Hospital tasks dumped on over half of GPs as COVID-19 creates 'tsunami of extra work'

GPs are facing a 'tsunami of extra work' because the COVID-19 pandemic has forced them to deliver care, tests and prescribing that would usually be carried out in hospitals, the BMA has warned.

A BMA poll of more than 7,000 doctors found 52% of GPs reported that since the pandemic started they have had to provide more patient care that would normally be delivered in hospitals.

The BMA said family doctors were being expected to perform blood tests for hospital outpatients, prescribe medication that would normally be given in secondary care, and complete tests before making a possible cancer referral, which could lead to delays in treatment.

Among GPs who said the care they were expected to provide had changed during the pandemic, 81% said they had been asked to carry out new investigations and manage ongoing care that would normally have been done in hospitals. A total of 74% said they had been asked to re-refer patients who are yet to be seen in hospital due to the pandemic.

GP workload

Some GPs warned they had been asked to carry out tasks that their local community system was not equipped for and had been forced to send the work back to hospital, potentially delaying care.

Poor IT systems and digital solutions linking hospitals with general practice are also contributing to duplication of work, the BMA has warned.

Findings from the poll come as the BMA's GP committee published 'Trust GPs to lead', a policy paper outlining five key principles for change in general practice after the pandemic.

Following calls from the BMA and the RCGP for a major overhaul of CQC processes after the pandemic, the paper demands a reduction in the burden of regulation on primary care.

COVID-19 pandemic

It also demands a reduction in bureaucracy and urges the NHS to 'capitalise on the greater autonomy provided to general practice during the pandemic'.

BMA GP committee chair Dr Richard Vautrey, said: ‘The NHS was always going to see a drastic increase in patient demand as COVID-19 arrived in the UK, but this crisis has truly shone a light on the lack of robust IT systems across the health service and the tsunami of extra work increasingly placed on GPs as a result.

‘This needs rapid action to deliver long-term solutions to improve the interface between secondary and primary care, and make sure we have the digital infrastructure in place to stop unnecessary prescribing, duplication of workload and extending patient pathways.

‘The longer this goes on, the more at risk we are of losing talented healthcare professionals which is why we desperately need to reduce the burden of unnecessary bureaucracy and regulation such as CQC inspections, put in place better digital systems, and provide general practice with the funding needed to deliver new services.’

NHS bureaucracy

During a primary care webinar last week NHS England officials confirmed they were working on plans to reduce bureaucracy that will feed into a review agreed as part of the 2020/21 GP contract.

One north London GP told the BMA: ‘Letters [from hospitals] stating that "due to the current situation" they don't want the patient to attend their hospital for blood tests, [ask] "please can you organise these blood tests in the community".

‘We have never had a commissioned community phlebotomy service and we certainly don't have one now. Our patients have to attend hospital for blood tests, so we have to write to them to explain and again, it takes time to do this.’

Another, from Hertfordshire, said: ‘Our CCG is starting to say that they will be looking at ways of changing how they work post-COVID-19. One of their suggestions is that they will open up more pathways for “advice and treat”.

‘My concern is that as referrals will all be pushed into these categories, we as GPs will be contacted by secondary care and asked to arrange this, that and the other, and then get back to them with the results. Essentially becoming house officers to secondary care and massively increasing our workload.’

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