Lessons from pandemic can shape sustainable post-COVID general practice, says RCGP

Reduced red tape and total triage should become permanent features of post-COVID general practice along with a shift in funding to support deprived and underdoctored areas, an RCGP report argues.

RCGP sets out post-COVID plan (Photo: Pete Hill)
RCGP sets out post-COVID plan (Photo: Pete Hill)

The college has identified three key elements of the general practice response to the COVID-19 pandemic that it believes have 'the most potential to transform general practice' to meet 21st century demands.

Reduced red tape, better use of digital technology and an expanded public health role for GPs have underpinned the huge shift in ways of working adopted by the profession since the UK went into lockdown in March, the report says.

The report published on 7 July, 'General practice in a post-COVID world', argues that GPs have been able to dedicate more time to patient care during the pandemic because of the suspension of regulatory checks such as CQC inspections and revalidation, and the sharp drop in QOF admin work.

Read more
>
More trust and less red tape must define post-COVID GP world, says RCGP chair

Writing exclusively for GPonline on the impact of regulation, RCGP chair Professor Martin Marshall said: 'The fact is that throughout the pandemic, general practice has functioned well with less regulation. GPs and our teams have demonstrated that we can be trusted to deliver high-quality, safe patient care without having to tick as many boxes to prove it.'

The college has also highlighted the opportunity to reshape services permanently through better use of digital technology adopted during the pandemic, and is calling for a major overhaul on areas such as appraisal and the QOF.

The report says there is a 'compelling case' for the total triage model adopted during the pandemic to be maintained permanently, to improve the use of different types of consultation to fit patients' needs and requirements.

More consultations should continue to be delivered remotely for patients who want or need this, the college says. Remote working has the potential to ease local recruitment problems in the profession, it adds - citing the example of underdoctored Hull using GPs in York to carry out phone consultations.

GP workload

However, it warns that this way of working does not in itself reduce GP workload and cannot come at the expense of the GP-patient relationship.

Technology should also be used for improved remote monitoring of patients' health and to create better links between different health and care services - and between GPs - through more data sharing, the college says.

The report also highlights the key role data collected from general practice has played in management of the pandemic - for example in identifying at-risk patients who needed to shield.

Meanwhile, the report calls for a re-balancing of GP funding to support underdoctored, deprived areas - warning that general practice will be at the heart of ongoing management of patients who experience long-term health problems after COVID-19 infection.

COVID-19

The report warns: 'It is vital, therefore, that we take action now to ensure that general practice is well-prepared to meet the post-COVID wave of secondary health problems. This means developing systematic approaches for GPs to proactively identify those patients who are most likely to require support in primary care.

'It also means taking decisive action to address the "inverse care law" whereby the most deprived areas are also those where it is hardest to recruit and retain GPs.'

Measures to cut bureaucracy called for by the college include 'intelligence-led monitoring of the quality and safety of care', with a high-trust approach to mechanism such as the QOF to limit administrative demands on practices.

The college is also calling for 'a new yearly appraisal system across the UK, minimising pre-appraisal documentation and the administrative burden on GPs and focused on wellbeing, reflective practice and development' - along with steps to make it easier for doctors to return to practice.

RCGP chair Professor Martin Marshall said: 'While we recognise that regulation has a place in general practice, the fact is that 95% of GP practices are rated good or outstanding. Making GPs and our teams go through box-ticking exercises has little patient benefit and isn’t the best use of our time, especially as we deal with the expected surge in clinical workload in the aftermath of COVID-19.

'It’s imperative we learn from the pandemic and strive to create a better-functioning "normal" for general practice, rather than simply returning to the way things used to be. We need governments to trust GPs to do our job well, and safely, and if they do, the ultimate beneficiaries will be our patients.'

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

GPs face tax problems as missed pension deadline forces PCSE apology

GPs face tax problems as missed pension deadline forces PCSE apology

Many GPs could struggle to plan for retirement after Primary Care Support England...

Patients who refuse to wear a mask could be denied face-to-face GP appointment

Patients who refuse to wear a mask could be denied face-to-face GP appointment

Patients who refuse to wear a face covering when attending a GP practice could be...

No plans for most GPs to open over August bank holiday, NHS England confirms

No plans for most GPs to open over August bank holiday, NHS England confirms

GP practices will not be asked to work over the August bank holiday unless they are...

More than one in five GPs have had COVID-19, poll suggests

More than one in five GPs have had COVID-19, poll suggests

More than one in five GPs may have had COVID-19, according to a BMA survey that shows...

Half of GP partners believe PCNs will improve patient care in the coming year

Half of GP partners believe PCNs will improve patient care in the coming year

Over half of GP partners believe primary care networks (PCNs) will have a positive...

GPs call for PCN mental health recruitment to be fast-tracked as cases surge

GPs call for PCN mental health recruitment to be fast-tracked as cases surge

Primary care networks (PCNs) must not be forced to wait until 2021 to recruit mental...