Devon GPs use innovative alert system to flag unsafe workload

Devon GPs have adopted a county-wide alert system to highlight when practices are facing unsafe workload pressure and need urgent local health system support.

Consultation (Photo: sturti/Getty Images)
Consultation (Photo: sturti/Getty Images)

The initiative rolled out by Devon LMC - thought to be the first of its kind in the country - asks practices to complete an anonymised weekly report in which they self-grade their workload and share stress levels.

Responses are compiled to report an overall alert status - ranging from green for low pressure to black to signify a crisis situation - at locality and county-wide level. Around 80 practices in Devon have signed up to the reporting system, with the latest county-wide report showing general practice at 'amber' - coping with some staff and resource shortages.

Devon LMC hopes the alert system will strengthen GPs' chances of securing ‘more resources and less bureaucracy’ to ensure good quality care for patients now and into the future. Several other LMCs around the country are understood to be considering the scheme.

Pressure gauge

‘Our innovative new reporting system will help provide robust evidence about the pressure faced by our local GP practices – and greater recognition of the scale and challenges,’ said Devon LMC chair Dr Bruce Hughes.

‘The pressure acute hospitals are under is well publicised and is captured by the OPEL Framework. General practice has had no equivalent and so the government, healthcare providers, commissioners and patients can sometimes assume that things are not so bad for local GP practices.

‘The alert status will help us strengthen our case as we continue to lobby for more resources and less bureaucracy to ensure local general practice is sustainable in the future so patients receive appropriate treatment, care and support for their clinical needs,’ he added.

Under the reporting scheme, local GP surgeries report weekly, with practices ‘in distress’ told to send a black status alert - the highest level warning - which signifies that it is ‘unsafe to continue without intervention from stakeholders’.

Alert levels

A red signal shows a GP practice is running 'safely under significant pressure' but requires 'immediate action' to mitigate the situation. It signifies the whole practice is under strain because of ‘staff shortages, increased patient waiting times and elevated levels of communications with stakeholders’.

A green status - the lowest status - indicates that the practice is running normally with waiting times at an ‘acceptable level’ and resources ‘largely in balance’.

Practices across Devon reported an amber status for this week, meaning surgeries are running with some staff and resource difficulties, patient waiting times remain acceptable - but that pressure is at a level that cannot be sustained beyond the medium term.

In March 2018 the BMA proposed a 'black alert' system for GP practices, allowing practices across a locality to take steps such as shutting down long-term conditions clinics and temporarily suspending planned early hospital discharges.

Meanwhile, doctors' leaders and health regulators recently called for an immediate crackdown on ‘unsafe’ workloads following the death of two GPs by suicide in the space of nine months.

The Devon-wide weekly alert status will be published every Friday on the LMC’s website.

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