Practices 'innovating to survive' as two thirds expand non-clinical workforce

Almost two thirds of practices in England hired extra non-clinical staff in the past 12 months to ease pressure on GPs, a GPonline poll suggests.

A total of 62% of 265 GP partners who responded to the poll said their practice had broadened its non-medical workforce to reduce demand for GP time over the past year. Some GP partners whose practice had not expanded non-clinical staff in the past year said they would have done so, but lacked either funding or space to widen skill mix.

Broadening the practice workforce 'to reduce demand for GP time and connect the patient directly with the most appropriate professional' is among the 10 'high impact actions' set out by NHS England to help build sustainable general practice.

But GPC chair Dr Chaand Nagpaul told GPonline that the findings showed general practice was 'making pragmatic decisions to survive'. Practices that had been unable to recruit enough GPs were often being forced to hire other non-medical staff, such as nurse practitioners, to fill the gap, he said.

GP workforce

Innovations by practices to cover gaps in the GP workforce were often 'extraordinary', the GPC chair said, such as training administrative staff to take on minor tasks that could free up GP time.

Dr Nagpaul said practices hiring more non-medical staff was more about survival than improving ways of working in general practice: 'I think this is more a case of practices showing determination, and making pragmatic decisions, to survive.'

The GPC chair pointed to recent BMA data that shows one in three practices have 'permanent holes' in their workforce because they have been unable to fill vacant GP jobs.

'In some cases practices are redeploying money where they cannot recruit GPs to bring in a nurse practitioner or other member of staff,' he said. 'There is an element of this that is about using resource that would have been for GPs, but GPs cannot be found.'

He added that other practices were 'using this to reduce workoad and free up GPs to focus on other work, ranging from GPSI roles to working in local federations'.

Practice workload

But Dr Nagpaul said that although the GPonline findings show that practices are 'looking at pragmatic ways' to deal with pressure, ultimately the profession needed 'greater resources for skill mix'.

'There is an emerging agenda where we are seeing GPs innovating and finding ways to address significant workload pressures. This is showing the determination of GPs to find ways to manage workload.

'It is extraordinary what some GPs are doing - such as using admin staff to handle letters that take up a lot of GP time,' he said. He also cited parts of England where every practice has support from a pharmacist. 'These are ways practices are looking to survive, but none will solve the overall issue that we need greater resources in general practice. That needs a bigger NHS pot.'

GPonline reported earlier this month on GPC warnings that general practice remained 'billions of pounds' short of funding despite additional funding from the GP Forward View.

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