Updated COVID-19 workload prioritisation advice from the BMA and RCGP warns that while public life is returning to 'normal' after the removal of pandemic restrictions, general practice remains 'under intense pressure'.
The advice has been updated to reflect the removal of the standard operating procedure (SOP) for general practice that was in place from early in the pandemic until last month.
The updated BMA/RCGP document has dropped national demands on workload prioritisation to reflect the SOP being scrapped - and no longer provides a 'response level' estimate of pressure on the profession nationally.
While a version of the guidance earlier this year warned that GP practices were under such intense pressure that most non-essential work should stop nationally, the latest advice says that the long duration of the pandemic has made it 'harder to provide meaningful national templates' defining how workload should be managed locally.
The advice adds that some work 'deprioritised' earlier in the pandemic may now need to be reviewed to ensure patient safety and wellbeing - warning that 'there is an increasing risk that national guidance is not reflective of local circumstances, clinical need, or contractual obligations'.
However, it remains clear that practices need support from NHS organisations to limit workload. The guidance says: 'External commissioners and organisations should be aware that there will continue to be significant variation in local capacity in general practice, subject to local circumstances, COVID-19 prevalence, and staffing levels.
'It is for practices to determine how they meet the reasonable needs of their patients, the document says, adding: 'Clinicians should continue to review and reprioritise workload, using clinical judgment and reflecting both patient need and local circumstances (such as staffing levels, local disease prevalence and patient demographics).
Suspend non-essential work
'Commissioners should also continue to limit or suspend additional expectations of practices, such as local enhanced services.'
A BMA update pointing out the update to the guidance said: 'As the COVID-19 restrictions are easing across the UK, the workload pressures caused by the pandemic remain at record levels, despite the success of the vaccination programme.
'The UK is currently moving through the third wave of infections, driven by the Delta variant. This is leading to large numbers of COVID-19 cases, albeit often less severe than in previous waves, many of whom are managed by GPs and their teams. General practice continues to deliver the vaccination programme but also provides routine acute and long-term care to patients and supports large numbers of individuals awaiting specialist assessment or treatment.'
GPonline reported last month that appointments delivered by general practice in June this year were up 31% compared with June 2019 once appointments for COVID-19 jabs were factored in.