Safe Working In General Practice
The BMA’s England GP committee (GPCE) has generated the following guide to enable practices to prioritise safe patient care, within the present bounds of the GMS contract.
Safe working in general practice
Pushing back on inappropriate workload
Updated Template letters for practice use
GPs and practices are under unprecedented pressure. There are about 340 million consultations annually in general practice in England, an increase of 40 million per year from five years ago. This represents the single greatest rise in volume of care within any sector of
the NHS. The increase has not been matched by an increase in GP numbers and staff, nor byan expansion in infrastructure, against a background of falling resource. There is now a large and increasing gulf between the workload demands on practices and their capacity to deliver essential services to their registered patients. GPs are being overwhelmed by rising workload, particularly from a growing ageing population with complex health needs. At the same time, there is an emerging workforce crisis with shortages of GPs leaving many practices unable to recruit doctors, and evidence that some experienced GPs are considering leaving general practice altogether. Government policy
continues to move services into the community, placing yet more pressure on overstretched GP services struggling to provide enough appointments, with consequential delays to see a GP. Cuts in resources to individual practices via imposed changes to correction factor and
PMS reviews are exacerbating the problem for many. This has followed year on year cuts in practice funding.In a recent BMA Tracker survey, 74% of GPs described their workload as unmanageable or unsustainable-significantly higher than any other category of doctor. Both the CfWI (Centre for Workforce Intelligence) and the HEE (Health Education England) workforce task group have reported that the current workload demands on GP practices are unsustainable, given current GP workforce levels.In this climate, it is crucial that the safe provision of core services to patients remains GPs’overriding core priority. This guidance is intended to help practices ensure this
This Guidance includes templates on:
- Copy Results sent to the GP which may require action by the test requester and which are not marked “for information only”
- Requests sent by another provider that the GP should “chase up” test results not requested in primary care
- Copy notification to the CCG of such episodes
- GPC Quality First Webpage
- Response to secondary care work transfer
- Response to inappropriate prescribing requests
- Response to requests to follow up investigations performed in other settings
- Response to requests for post-operative checks
Additional NHS Standard Contract letter templates for practice use
Includes:
- Response for missed appointment
- Delayed Dicharge summaries
- Delayed Clinic Letters
- Response for onward referral
- Provision of medication following discharge
- Follow up results and investigations
- Letter to CCG informing breach by provider
Further templates contained in Quality first: Managing workload to deliver safe patient care
- Template letter for request to complete non-contractual administrative task
- Template response to requests for work absence sick notes for less than seven days
- Template letter to Area Team regarding delay to information request or payment
