Overflow service could cut GP workload to 25 appointments a day, says BMA

The BMA has set out proposals for an overflow service to reduce GPs' workload to 25 consultations a day.

Dr Brian Balmer: government must deliver on GP funding pledge
Dr Brian Balmer: government must deliver on GP funding pledge

NHS commissioners should pay for ‘locality hubs’ to provide additional routine and urgent, core and extended hours appointments to reduce demand on practices, the doctors' union has said.

The plans were first proposed in the BMA’s Urgent Prescription for General Practice in April 2016 and subsequently supported by NHS England in the GP Forward View.

GPonline reported in May on poll findings that showed two thirds of GPs believe the NHS should cap the number of consultations they can deliver per day at 30 or less.

GP workload

Despite opposition from some LMC leaders at their annual conference in May, the BMA has now published more detailed proposals.

Commissioning either GP practices or other providers to run hubs that provide additional appointments could reduce demand on the core service, according to the plans.

Appointments should be lengthened to 15 minutes, with each GP limited to 115 face-to-face consultations a week, under 25 a day.

GMS and PMS contracts should in future ensure that practices are commissioned by the number of appointments offered, encouraging them to limit clinical work to within safe parameters, the BMA says.

‘The sole initial purpose of locality hubs is the stabilisation and sustainability of general practice,' the union's proposal said. ‘Hubs are not walk-in centres: each hub would help manage demand across a number of practices and their respective patient lists, ensuring that patients in excess of safe working limits can still be seen by a GP or the wider primary care health team.’

Patient safety

The new report provides GPs and commissioners with five case studies where local GP access hubs have been piloted by alliances or federations of practices covering between 39,000 and 152,000 patients.

The BMA set out a set of principles to inform development of hubs:

  • Sufficient recurrent funding 
  • Flexibility in the model according to local need
  • Core opening hours
  • Co-ordinated triage
  • A range of services
  • Collaboration supported by IT systems

GPC executive member Dr Brian Balmer said: ‘We need a new approach that shakes up the way patients get their care from their local GP practice. The consultation time needs to increase to 15 minutes with the government providing on its promised funding to make this work.

‘As part of the package, more GPs must be put in front of patients so that the number of consultations per GP a day falls to a sustainable level. We need to learn from best practice across the UK and look at options, where appropriate, for organising GP practices into hubs, where knowledge and resources can be shared.

‘General practice in the UK cannot be allowed to continue being run into the ground: it’s time for positive change that gives patients the care they deserve.’

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