A survey of 1,250 RCGP members by Ipsos Mori found that 34% had worked in partnership with other practices or pharmacies to try to control workload.
The survey results were published in the college’s first annual assessment of NHS England’s Five Year Forward View.
CCGs have been told, as part of the Forward View, to allocate a one-off £3 per head transformational fund to support practice collaboration. The £171m total CCG funding is supposed to be delivered between 2017/18 and 2018/19. The RCGP report said that while ‘most CCGs have made the appropriate provision’, some plans ‘are not fully assured at this point’.
The GPC has previously warned that transformational funding was in some areas being tied to cost savings or additional requirements.
In March NHS England announced that further financial support would be available to encourage every practice in England to join a primary care network of at least 30,000 to 50,000 patients, although further details have yet to be revealed.
The GPFV included a £30m ‘Releasing time for care’ programme to support practices to release capacity through the ‘10 high impact actions’. These include active signposting, new consultations types, social prescribing, and partnership working.
Forward View commitments on workload include:
- Investing £30m in a development programme to help release capacity.
- New contract measures to improve the interface between primary and secondary care.
- A maximum interval of five yearly CQC inspections for good and outstanding practices.
- CQC to consult on changes to its regulatory model with the aim of reducing the regulatory
- burden for practices that deliver good or outstanding care.
- A national programme to help practices support people living with long-term conditions to self-care.
The college’s poll asked GPs what steps, aligned with the 10 high impact actions, they had taken to try to reduce workload.
The most popular answer was managing work flows better, which 57% of GPs said they had done. Next, 56% said they had tried new consultation methods such as by phone, and 56% had tried improving internal processes. Fifty-three percent said they had taken on additional non-GP clinical staff.
The report revealed that to date there had been 90 schemes covering 3,600 practices and 2,486 people had taken part in time to care workshops. So far just £8m of the £30m promised has been invested in the programme. ‘This implies that a further £22m is to be spent over the next two years, suggesting many more practices and people working in general practice will be reached,' the RCGP report said.
It added that while NHS England has said practices can release 10% of GP time through the programme there was ‘insufficient evidence to indicate whether it will have this impact’.
‘To ensure it does, NHS England must conduct a thorough evaluation of the programme and adapt support where necessary to ensure it genuinely makes a difference to GP workload. Struggling practices should also be proactively encouraged to participate.’
It added: ‘Many of the schemes contained in the GP Forward View aimed at addressing the issue of workload are being implemented. However, it is disappointing that GPs are reporting little impact on their day-to-day workload. Overall, the college is concerned that the strategies to address workload in the GP Forward View will not be sufficient for the scale of the task.’
The report called for:
- NHS England to review with stakeholders what more can be done to reduce GP workload to a manageable level.
- The CQC should conduct and publish an impact assessment of their proposed changes to CQC inspections in general practice. In particular they should indicate the change in regulatory burden expected as a result of each proposal.
- The CQC should use the opportunity of changes to the regulatory inspection regime to consider the reduction of fees to prevent money being diverted away from frontline patient care
- NHS England and NHS Improvement should raise awareness of the changes to the NHS Standard Contract amongst trusts and hold commissioners to account to ensure the new contract terms are introduced and enforced.
- NHS England should continue to develop collaborative care and support planning for people living with multiple long-term conditions, with protected time for practices to receive training.
- NHS England should continue work with other organisations and the profession to develop a successor to QOF, with reduction in administrative burden made a key test for the development of the replacement.
- NHS England should form a working group to investigate and clarify mandatory training requirements.
- Work should begin with payment providers to streamline payment processes for practices to focus on improvements to consistency and accuracy of payments.