Hospitals should be fined for dumping work on GPs, say LMCs

Hospitals should be fined for dumping work on GPs in 'flagrant' breach of their contracts - with funding transferred to primary care for all work transferred, LMCs have warned.

LMC conference (Photo: JH Lancy)

GPs at the annual England LMC conference expressed ‘deep concern’ at the ‘flagrant contravention of the standard hospital contract’ and asked GPC England to develop methods to decrease the amount of work passed to them by hospitals.

LMC delegates called for a formal audit of unresourced work carried out by GPs that should be done elsewhere, and backed financial penalties for trusts when the standard hospital contract is breached.

GPs also called for the transfer of appropriate funding to general practice with each identifiable breach, asking for the issue to be made ‘a red line’ in upcoming 2020/21 contract negotiations.

GP funding

GPonline revealed last year that practices were delivering services worth millions of pounds for free as they continued to deliver services outside the core GMS contract. Around seven in 10 GP partners said their practice delivered at least one non-core service for no extra money.

Gateshead and South Tyneside LMC Dr Paul Evans told the LMCs conference it was time to use financial incentives to reduce the frequency with which hospitals were dumping work on GPs.

‘We’ve discussed [breaches of contract] with secondary care for the last two and a half years and we have been promised time and again that they get it and they will stop breaching, but they don’t and they never will.

‘This needs financial levers - every service that is delivered, every BMA template letter that goes in to the CCG needs to see the trust deducted money, money that is put into general practice and given to those who the work is dumped upon… it’s time to push back.’

Workload

Meanwhile, North Yorkshire LMC's Dr Aaron Brown, who raised the motion, said: ‘The contract that the BMA negotiated to reduce our workload dump has failed… [and] the black and white rules are being ignored on a daily basis.

‘Every single GP in this room can probably recall an example within the last week of these rules being breached and those who cannot are likely a victim of doing unfunded work so often, it has become white noise. We must stand up to NHS England and make it an absolute red line for upcoming contract negotiations.’

GP leaders have warned previously that NHS managers are failing to enforce changes introduced in 2016 to the NHS standard contract to ease pressure on GP services. It's been estimated that hopsital work taken on by GPs is wasting 15m GP appointments per year.

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