Bureaucracy and tiresome admin are the bane of every working GP’s life. There is nothing more frustrating that finding yet another directive from some sub-office of the DH or NHS England that results in an hour spent filling in forms, completing an audit or validating data that could have been more productively used doing clinical work that benefits patients. How many appointments are being swallowed up by paperwork that really benefits no one?
GP magazine’s latest survey of 600 GPs underlines this point. It shows a high number of GPs engaged in often unresourced work. Hospitals referring patients back to GP practices for medication or to chase up results they initiated – which close to nine out of 10 GPs object to – are clear problems.
The reason why most GPs put up with this illogical situation is a belief that they have to do it. However, as the BMA’s GP workload guidance demonstrates there are plenty of tasks that many GPs are carrying out which they are wrongly assuming are part of their contractual obligations. In truth, there are many areas where GPs could safely push back to their CCGs, area teams or hospitals in order to concentrate on what everyone became a GP to do: treating patients.
The BMA’s guidance has a substantial section listing work that GPs may well be doing unnecessarily. Some work is quite rightly a statutory obligation, such as information recording related to child protection and safeguarding data. However, there is a great deal of non-compulsory, non-NHS work that many practices are within their rights to decline such as issuing return to work notes, providing a letter for school absence for minor illness or the simply bizarre request for a letter saying someone is fit to exercise at the gym.
Onerous demands on GPs
Every GP needs to be aware that some requests for information cannot be declined and in the terms of our contracts local area teams (and their equivalents in Wales and Northern Ireland) can make reasonable demands for information. However, if the practice feels it is onerous they should discuss it with their local LMC.
Saying 'no' to these kind of bureaucratic demands doesn’t come naturally to GPs. We are trained to help, after all. But given the incredible workload pressure on GPs, which in some cases is threatening the very viability of practices, we have to start looking at refusing to do unnecessary work, as long as it does not have any impact on patient care. It is time to start changing the culture in the NHS, a culture that believes over-the-top data recording and mountains of paperwork are in some way key to general practice’s success. It is an absurd logic that we all need to end.