Stopping work transfer from hospitals tops list of GP demands to tackle workload

Stopping hospitals dumping tasks on general practice tops a list of measures GPs say are vital to ease pressure on primary care - with extra funding, a freeze on QOF and CQC inspections, and educating patients on access also widely backed.

GP workload concerns (Photo: Martin Prescott/Getty Images)

A total of 86.3% of 590 GPs who responded to a GPonline poll on workload called for steps to limit the transfer of work from secondary to primary care.

Changes to the standard NHS contract in 2016 and 2017 aimed to block unfair dumping of work on primary care - including a ban on hospitals forcing GPs to re-refer patients who miss appointments, making hospitals communicate test results direct to patients, and halting the transfer of responsibility for fit notes, medication or patient queries.

But GPs warned earlier this year at the 2021 UK LMCs conference that hospitals were dumping 'endless tasks' on primary care, compounding already intense workload after more than a year of working in the COVID-19 pandemic.

GP workload

A publicity campaign to educate patients about access to general practice was the second most widely backed measure to ease workload in primary care - with 81.5% of GPs supporting the move.

The call comes after a year of intense pressure on general practice over access to face-to-face appointments, with damaging media reports and statements from public figures suggesting that practices have been 'closed' during the pandemic.

An MP asked on 27 July in parliament what the government was doing to encourage GP practices to 'return to in-person appointments' - despite more than half of appointments being face-to-face throughout the pandemic, in addition to tens of millions of in-person patient contacts as part of the COVID-19 vaccination campaign.

Three quarters of respondents to the GPonline poll called for additional funding to support general practic, while three in five called for the suspension of CQC inspections and half called for supension of QOF.

Supporting GPs

Responding to GP appointments data that show GP practices delivered 31% more appointments in June 2021 than in June 2019 including work on the COVID-19 vaccine campaign, BMA GP committee chair Dr Richard Vautrey warned that 'general practice is in clear need of support'.

The RCGP has also called for an emergency package of support for 'crisis-torn' general practice, warning that the profession is under unsustainable pressure and at breaking point.

One GP responding to the survey said the profession was facing 'unprecedented pent-up demand'. The GP wrote: 'We are all dealing with multiple problems in longer consults for increasingly frustrated and anxious patients. Need to release funding for individual practices to manage their population and demand independently and stop unreasonable and unfeasible call for constant "increased access".'

Another wrote: 'The daily workload is unmanageable for any individual. The solutions include re-educating patients on what is appropriate for a GP's time. Secondary care colleagues should not treat us as their secretaries or housemen. Every request for contact with a GP must be first screened and triaged appropriately.'

Workforce crisis

GPs responding to the poll highlighted concerns that unsustainable pressure on general practice would lead to a deepening of the workforce crisis, with respondents calling for 'significant investment in recruitment'.

GPonline reported earlier this year that there are currently 10% fewer GPs per patient than there were in 2016 despite government promises to increase the workforce.

One GP said: 'We need more GPs. Also need to agree on a safe number of patients for a surgery based on GP numbers. Once we hit the safe number for the practice, we close our list and can only take patients on if we have more capacity or if patients leave the practice. This will improve quality.'

Another wrote: 'It's just impossible We are drowning and losing excellent doctors in the process. There is no job satisfaction in essentially being a jobs-body for secondary care and a jobs-body for the public. Every day we are pounded with criticism from the media and public - how can you expect us not to be completely demoralised?'

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