LMCs set out potential solutions to halt growing GP workload crisis

LMCs have set out proposals to tackle the growing workload crisis in general practice - backing measures such as scrapping CQC inspections, tracking GP activity, a major review of the workload crisis, suspension of QOF and changes to PCNs.

In an extended debate on stemming the GP workload crisis at the 2021 UK LMCs conference, GPs proposed a system to alert LMCs when practices are dealing with a high number of consultations.

LMCs also argued that QOF and PCN service specifications should to be relaxed to take pressure off practice teams, while some GPs called for greater flexibility around spending network recruitment funding.

GPs also hit out at a constant flow of work dumped on primary care by hospitals - and voted against taking on more secondary care work regardless of whether funding was offered. Some speakers argued hospital trusts should be fined for dumping work at the door of primary care.

GP workload

The debate came after BMA GPC chair Dr Richard Vautrey told the conference that general practice is facing 'historic workforce and workload crises' - and needs a long-term government funding commitment to recover from the pandemic.

Official statistics show that practices in England delivered 28,570,000 appointments in March this year, compared with 23,720,000 in February - a 20% rise.

Devon LMC representative Dr Mo Morris argued that an alert system - similar to one develop in his area - should be developed to record GP activity data and reflect how busy general practice is working to keep staff and patients safe.

He said: 'Without the awareness of what’s going on in general practice it’s easy for the media, government and patients to assume that things are running smoothly. Our [flagging system] involves a snapshot of the number of contacts that practices have seen on a specific day of the week.’

Patient contacts

North Yorkshire LMC representative Dr Brian McGregor argued that the profession needed to have serious discussions about limiting the number of contacts GPs had with patients, and to stop the trend towards GPs working 12-14 hours days.

Hertfordshire LMC representative Dr Frances Cranfield went one step further by arguing that the astronomical workload volumes in general practice represented a ‘health and safety’ issue which needed government intervention.

She called for a review to look at the 10-minute consultation model, patient list sizes, working hours, and physical work conditions and see how it affected clinicians’ ability to deliver patient care.

‘We need to ask the GPC to ask the government to set up this review now. And then all of us need to be ready and prepared to undertake changes to make this system safer and to ensure general practice remains the jewel in the crown,’ she argued.

QOF suspension

Other GPs asked for more immediate changes to general practices including the suspension of QOF and revised thinking around how PCNs used recruitment funding - allowing networks freedom to recruit to any position they felt was needed in their local area.

Cambridgeshire GP Dr Ben Curtis said: ‘[We need] a substantial increase in GP funding so we can spend money where we deem it appropriate. [We also] also need relaxation of all QOF and enhanced service targets. Thirdly, we need light-touch, welfare orientated appraisals and fourthly we need to get rid of the cobra in the picnic basket: the CCQ.’

Dr William Dougal from Wessex LMCs also suggested that GPs should be alloted time in their week to catch up on daily administration tasks and to support this with funding.

GPonline reported last week that practices were drowning under a tsunami' of work, with clinicians warning GPonline of a possible workforce exodus should the situation remain unchanged.

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