As GPs, it is clear to us that unmanageable workload, fuelled by inadequate resources and capacity, is the root cause of the crisis affecting our profession.
The BMA GPs committee is in active dialogue with governments across the four nations to address this with new resources and support for general practice. Meanwhile, given we are short of several thousand GPs, it is crucial that as a profession we are enabled to stem excessive, inappropriate or unresourced work, to help GPs to provide safe, quality care to patients. That was the reason why GPC last year published our Quality First: Managing workload to deliver safe patient care toolkit which sets out practical measures practices can consider and adopt to control their workload.
Visit our new webpage to control workload
We are building on that guidance by launching a dedicated BMA ‘Quality First’ web portal aimed at individual GPs, practices and local medical committees as a single portal for a range of practical ways in which we can manage workload to deliver safe care, with ‘how to’ and real examples of effective practice.
Areas covered include:
- Managing inappropriate workload
- Collaboration and working at scale
- Technology – new ways of working
- Patient empowerment
- Assessing and negotiating workload.
We have included template letters to help practices to push back on inappropriate workload demands, such as specialist prescribing requests or unresourced non-core workload transfer. These are now ready to be exported into practice systems with ease (via SystmOne, EMIS and Vision), to automate the process. We would advise that you discuss with your LMC and CCG (clinical commissioning group) how best to coordinate the use of these letters to ensure that they achieve the maximum impact.
There are also links to real case studies of where successful workload management has been achieved, for example:
- A primary care appointment hub system which has enabled practices to achieve 15 minute appointments with a limit on workload, and with ‘overspill’ activity being absorbed by the hub
- The use of skillmix to free up GP time, such as extended community nursing teams and extended scope practitioners, to reduce workload and optimise patient care
- Telephone triage service to free up time that could be spent instead with long term sick and vulnerable patients.
Of course, we know that there will not be a single panacea, and some examples may not be suited to certain practices or areas. However, we hope to provide an evolving menu of ideas to support GPs and staff that they can draw upon to meet their specific needs.
Investment to manage workload
Most practices are so overworked that they don’t have the headspace or minutes in the day to make changes. GPC is therefore pushing NHS England for new resources and dedicated support for practices for workload management, and which is linked to the ‘releasing time to care’ programme in the GP Forward View. Additionally, practices should, as members, put pressure on their CCGs to invest in reducing workload pressures on GPs as a legitimate local priority.
We hope this will be part of creating a sense of empowerment and resilience for GPs, at a time of overwhelming pressures. We intend that this site will become a dynamic resource, being added to and evolving as per feedback and new examples that we receive from around the country.
We are also inviting members to share their experience via Connecting Doctors (formerly BMA Communities) and you can join the conversation on twitter via #GPworkload which is the hashtag we will be using to promote this work and engage GPs around the country.
Your feedback is valuable and will be listened to, so do take the time to email us your thoughts.
With best wishes,
BMA GPs committee chair
Influencing the GP Forward View
GPC has been actively involved in influencing the implementation of the GPFV (GP Forward View). GPC is represented on the national advisory oversight group, which met last week. I made it clear that there needs to be urgent tangible delivery of resources and support, coupled with a reduction in inappropriate and unresourced workload, to stabilise the precarious state of increasing numbers of practices.
On this note, GPC has had a meeting with NHS England regarding the forward view’s practice-resilience programme, which has £40m funding, of which £16m is available this year. We are also feeding into the GPFV’s ‘releasing time’ programme, aimed at providing practices with support to release capacity for GPs, as part of managing workload and demand.
LMCs will play a key role to ensure that the GPFV’s schemes and funding reach practices to support them without new hurdles. We have therefore secured agreement from NHS England for GPC to set up a regional ‘LMC reference group’ to cover all areas of England. The reference group will provide real-time feedback of implementation and will also input into GPC’s national dialogue with NHS England.
GPC is also in direct dialogue with NHS England and the Department of Health to address soaring indemnity costs affecting GPs, and which is a commitment from the GPFV. We have distributed an NHS England indemnity survey to GPs via LMCs, to assess the extent of rising indemnity costs, and their impact on GPs. Thank you to those of you who have responded.
Understanding changes to your practice’s funding
The 2016/17 general medical services contract agreement saw significant investment in general practice. Taken together with the ongoing recycling of seniority and correction factor payments, as well as recent funding commitments and developments, there are significant changes, now and in the near future, to how general practice is funded.
We have published a ‘Focus on practice funding’ guide, which provides a summary of the funding changes and highlights some further developments that will impact on general practice funding.
BMA annual representative meeting 2016
This year’s BMA annual representative meeting is being held next week in Belfast from Sunday 19 to Thursday 23 June 2016. As you know, the ARM is the engine room for driving BMA policy and this year we have many important motions under the general practice section of the agenda, ranging from calls for a workload analysis to define the safe limits of general practice and preserve patient safety, to calling for adequate core funding for consultations that meet the needs of patients with complex, multiple comorbidities.
For those who are not attending, download the agenda and find out details of how you can follow a live webcast. The GPC section of the agenda is on Wednesday 22 June at 3.30pm; I do hope that you will be able to tune in to follow the debate.