Primary care teams need support to manage spiralling workload, warns PCN network

A clear plan to help primary care teams manage growing workloads must be developed to protect staff against burnout and guarantee safe patient care, a leading representative of PCNs has argued.

GPs under pressure (Photo: Luis Alvarez/Getty Images)
GPs under pressure (Photo: Luis Alvarez/Getty Images)

NHS Confederation PCN Network director Ruth Rankine told GPonline that action was needed to make workload sustainable and help primary care teams deliver on future work such as the COVID-19 booster campaign planned for autumn.

She said there was no system at present to show accurately the volume and complexity of work carried out by primary care - and called for a plan to be developed by July.

The PCN network director's comments come as the BMA warned last week that GP teams were ‘at breaking point’, with statistics showing that practices delivered 4.8m more appointments in March compared with the previous month - and as polling found one in three GPs now plan early retirement.

GP workload

Ms Rankine added that a strategy to manage workload could help practices ensure they were operating safely, but highlighted that pressure had already led to some areas reverting back to working 'in silos'.

GPonline reported earlier this month that some PCNs were pulling out of delivering phase 2 COVID-19 vaccinations due to workload and workforce issues, despite a willingness to get the job done.

Figures on GP appointments from NHS Digital show that GP practices in England delivered 28,570,000 appointments in March this year, compared with 23,720,000 in February - a 20% rise.

However, Ms Rankine said: ‘Part of the problem is that, although we know from what our members are telling us that their workload has increased significantly, we don’t have a way of measuring it at a national level other than by appointments. That only gives one small part of the picture. What we need is better data on primary care workload, in the same way we have for secondary care.

Complex consultations

‘[This means] we don’t have the ability to say that primary care is at breaking point and back that up with the evidence.'

Ms Rankine argued that increasing complexity of consultations, in addition to increased numbers of appointments, were concerning primary care teams - urging NHS leaders to act swiftly.

She said: 'Our members are understandably worried about how they manage the backlog at the same time as dealing with increased, and often more complex, demand while delivering a vaccination programme.

‘What they want is a national framework that helps them prioritise, supports them to make the right decisions on those priorities and manages public expectations about what is achievable. We need to build on the collaboration we have seen during the vaccination programme and the system needs to enable providers to work together on recovery.'

Vaccination campaign

She added: 'We want to see PCNs being given greater flexibility within the national contract to decide the right approach to manage the needs of their local communities.’

Chair of the BMA GP committee Dr Richard Vautrey, said: 'The government must act urgently to relieve some of the pressure in general practice, including beginning to have honest conversations with the public about just how strained things currently are, and being clear about what services and self-care options are available for minor and self-limiting conditions so that GPs can continue to offer care to those who really need it.

'As we have highlighted during the pandemic – including in our Trust GPs to lead document - practices must be better supported around how services are delivered, and enabled to focus on seeing patients rather than admin and burdensome bureaucracy.'

He added: 'We ask the government and NHS bodies to ensure that any plans devised to tackle GP workload takes a strategic, from the ground up, approach rather than simply telling GPs what to do – this is the only way to ensure that plans are to be effective and implementable.'

Soaring demand

Over the past few weeks GPs have highlighted the immense pressures that they are under, carrying out COVID-19 vaccinations, handling increased volumes of consultations and restarting work such as QOF.

Workload figures for March are the highest recorded since October 2019 - and is likely to significantly underestimate workload because multiple telephone appointments can appear as a single event in the data.

GPs have demanded an urgent review into soaring demand on general practice, after claims patients are struggling to access care despite the profession currently seeing '10% of the population each week'.

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