BMA demands GP workload cap to protect patients and doctors

GP workload should be capped 'for the safety of patients and the sanity of GPs', doctors' leaders have said.

A motion passed overwhelmingly at the BMA’s annual conference in Brighton called for a ‘sensible cap’ on workload to reduce risk for patients and to protect GPs.

The vote followed a speech in which GPC chair Dr Richard Vautrey warned that general practice was facing a 'serious risk of collapse'.

Proposing the motion - put forward by the BMA's Gwent and South Powys division - Dr Satish Narang said: ‘The crisis in primary care is not looming but we are living it, and it is generally getting worse by the day.’

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‘If forced to take on more and more work - without additional funding, workforce and resources - the consequence will be that the quality of work will be compromised and unsafe in terms of patient care,’ he added.

‘Unless we make some noise and take some action we will start exposing ourselves to higher and higher risk and it is not safe for the patients and it not safe for the GP and it is not safe for the profession.’

Consultation cap

This comes just months after a GPonline poll found that four in five GPs would support a cap on face-to-face consultations, with most supporting a limit of 30 or fewer.

Also arguing for the motion GP partner Dr Mary McCarthy said that - while a specific limit isn’t necessarily required - a recognition of what constitutes a ‘safe’ amount of work is.

‘All I want people to recognise is that seeing 25 patients a day is a reasonable amount of work to do. Seeing 50, 60, or 70 patients a day, every day, year on year, is not safe. It’s not safe for the doctor and it’s not safe for the patient.

‘I think [workload caps] should be viewed like a speed limit, and I speak as someone with points on their licence. There are occasions where you do break it - flu epidemics or a busy day in which you do see more [patients]. But that you do recognise that you’re working at an unsafe level… Let’s just be safe and drive at a safe speed.’

Workload

However, East London GP Dr Jackie Applebee argued that ‘there are plenty of other things we could limit’ than face-to-face consultations. She said: ‘A GP does not just consult all day. We could collectively refuse to comply with CQC; similarly with appraisal - both take us away from patient-facing care where out time would be better spent.’

She added: ‘Last summer, 54% of GPs who responded to the GPC survey said that they would be prepared to temporarily close their lists new registrations on the ground of patient safety due to excessive workload. Doing this together in a planned and coordinated way would allow us to look after our existing population more safely,’ concluding that simply capping consultations ‘will not solve the crisis in general practice and will be too difficult to implement.’

Despite health and social care secretary Jeremy Hunt's pledge to increase the GP workforce by 5,000 by 2020/21, GP numbers remain in decline while numbers of patients - many with multiple long-term conditions - go up, leading to increased GP workload and pressure.

GPC chair Dr Richard Vautrey backed the call for a cap on GP workload. He said: ‘We have started working on this issue we have produced a paper describing how we can provide some safe limits for practices how they can take control of that.’

BMA chair Dr Chaand Nagpaul added: ‘It is a challenge to define limits but it certainly makes sense to address safety issues in general practice.’

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