Viewpoint: We must control GP workload, says Dr Chaand Nagpaul

In the first of a series of articles for GP magazine, GPC chairman Dr Chaand Nagpaul spells out how practices can continue to provide safe care amid soaring workload pressure.

Dr Nagpaul: work guidance
Dr Nagpaul: work guidance

GP workload has reached unprecedented, unmanageable levels that have far outstripped our capacity.

There are not enough GPs and appointments to cope with record demand, and this overwhelming pressure is undermining our ability to provide safe, high-quality care.

This is why the GPC has produced new guidance, Quality first: managing workload to deliver safe patient care. It comes as GPs are trying to square an impossible circle, seeing up to 60 patients a day, many with complex multiple problems, in the utter inadequacy of 10-minute slots.

Analysis: Can GPs control their workload?

There are escalating telephone contacts, while we plough through hospital correspondence, test results, repeat prescriptions, writing reports, meeting targets, attending meetings, as well as the rigours of running a GP practice.

No wonder 74% of GPs in the recent BMA tracker survey said their workload was unsustainable. Working under this strain is untenable for GPs and unfair to patients.

The safe provision of care must remain GPs’ overriding priority. GPs’ default tendency is to do as much as they can for patients. However, by taking on work GPs should not be doing or that lacks the necessary resources, capacity or competence, practices will be less available for patients’ core needs and will compromise quality and safety.

Our guidance offers tools to stem inappropriate, unresourced work, including templates to send to commissioners, providers and other agencies. It offers pointers for reducing bureaucracy, reviewing voluntary additional work and managing the practice’s list size.

Resources for practices

It covers practices working together to share resources and support each other, and developing new systems for IT and self-care.

Many pressures arise from local systems, such as unfunded transfer of work. These need to be addressed locally, which is why this guidance should be particularly useful.

I urge you to use it as a springboard for setting up a practice meeting to discuss managing workload, and keep this as a rolling agenda item.

Discuss workload management in peer groups of practices and contact your LMC for advice. In England, practices should require CCG boards to use their powers to halt inappropriate workload shift.

I have written to every CCG, suggesting a standing item in all board meetings on addressing GP pressures, and to ensure an impact analysis on practice workload of any commissioning decision.

I am delighted GP is giving this urgent issue due prominence and we look forward to contributing to a
series of articles on putting these ideas into action.

Read the GPC guidance in full

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