Hospitals still wasting 15m appointments a year by dumping work on GPs, warns GPC

NHS hospitals across England are wasting around 15m GP appointments a year by dumping work unnecessarily on practices and are ignoring a clause written into their contracts to prevent this, the BMA has warned.

The GPC has published a raft of template letters to help GPs push back against hospitals that are continuing to dump work on them unfairly.

The NHS standard contract - which hospital providers work under - was altered for this year after talks between the BMA and health service leaders. The changes bar hospitals from forcing GPs to re-refer patients who miss appointments, aim to make hospitals communicate test results directly to patients and mean patients can be referred on to other departments within a hospital rather than having to go back to their GP.

But GP leaders say NHS managers have simply failed in many areas to enforce changes to the hospital contract. The warning echoes findings from a GPonline poll published earlier this year which found that 73% of GPs said their local hospital still operated blanket policies that meant patients who miss hospital appointments are sent automatically back to their GP.

GPC chairman Dr Chaand Nagpaul said: 'Following sustained lobbying from the BMA, the NHS standard contract for secondary care trusts was changed during recent negotiations to ensure systems are in place to prevent unnecessary workload being diverted to GPs that could and should be handled by secondary care providers.  NHS England estimates that around 15m appointments are wasted because GPs are forced to carry out unnecessary administration like those caused by these issues with the standard contract.

GP workload

'Despite these new requirements, it is clear many NHS providers are not implementing these changes. The BMA has already ensured NHS England issued an instruction to managers reminding them of their responsibilities. However, alongside this the BMA is providing GP practices with template letters to redirect inappropriate demands back to hospitals to fulfil their contractual obligations.

'Given the enormous pressures on general practice from rising demand, falling resources and staff shortages, we need to end the scandalous situation where everyday thousands of patients will see a GP purely for the bureaucratic purpose of re-referring after a missed hospital appointment. This is a waste of precious resources, and is directly denying patients access to GP services. We must use GP appointments for medical reasons, and liberate time for GPs and their staff to care for patients.'

Speaking after NHS England wrote to hospitals to remind them of their contract responsibilities earlier this year, an NHS England spokesman said: 'Recent changes in the NHS standard contract set out clear legal requirements aimed at cutting the burden of bureaucracy on GPs, which is not good for local health services or patients.

'These changes must be driven at a local level by CCGs, working with their hospital colleagues.'

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