Wide-ranging overhaul of GP bureaucracy promised amid spiralling practice workload

Revalidation, referral processes, coding of patient data and letters required from practices could be overhauled under a drive to ease unsustainable workload by reducing bureaucracy in general practice.

Paperwork (Photo: Jose A Bernat Bacete/Getty Images)
Paperwork (Photo: Jose A Bernat Bacete/Getty Images)

GPs will be consulted in the coming months as part of a cross-government review to ‘reduce the bureaucratic burden’ on practices, announced as part of the 2020 GP contract deal.

The review, which will conclude in 2020, will produce recommendations agreed with the BMA to free up valuable GP time. The government has yet to confirm what the review will focus on beyond workload generated by legal aid letters for victims of domestic violence - but factors such as the sharp rise in work for practices after the GDPR was introduced in 2018 could feature.

A parallel piece of work will be carried out by NHS England and Improvement (NHSE&I) that will consider how to simplify revalidation and reduce time spent preparing for annual appraisal - as well as to 'reduce the burden associated with annual coding requirements for patients with long-term conditions' and to improve electronic referral and prescribing processes.

GP workload

The NHSE&I review will also consider how to take 'effective action' to enforce hospital contract clauses intended to stop them dumping work on GP practices - and how patients can be supported to 'self-refer' to community health services where possible.

GPC chair Dr Richard Vautrey promised to ‘bust’ bureaucracy at the BMA’s annual PCN conference earlier this month and told delegates that he was convinced health minister Jo Churchill was ‘very committed’ to reducing unnecessary activities in general practice.

Speaking to GPonline, Dr Vautrey explained how the voices of frontline GPs would be incorporated in the review. He said: ‘Increased bureaucracy is a daily headache for GPs and practices, taking valuable time away from what family doctors and their teams do best – providing care to patients.

‘We know GP workload is at an unsustainable level, and the BMA has long been campaigning against unnecessary admin in general practice, much of which centres around doctors being requested to produce reports or sign letters that shouldn’t need GP input or indeed the input from any healthcare professional.

‘The pledge of a government review comes as a direct result of BMA pressure on this issue, and we will be informed by the profession as to what they want to see change so that doctors and practice teams are able to focus on treating patients.’

Revalidation

Practices could be expected to begin work on digitising Lloyd George patient records from April 2020. The 2020 GP contract deal says work is 'already underway' to get this process started. However, despite the process being intended to free up space for extra staff in primary care and help ease workload - in the medium term GPs have warned that digitising Lloyd George records could create 'millions of hours of extra work' for general practice.

Last December, a GMC report found that almost half of GPs were dissatisfied at work, with bureaucracy among the key factors cited for unhappiness. Meanwhile, the number of full-time equivalent GPs in England went down by 340 in the year to September 2019.

A DHSC spokesperson said: ‘We are committed to freeing up clinical time by reducing wider pressures on doctors and other professionals in general practice.

‘As part of the 2020/21 GP contract we have committed to a full review of the burden of bureaucracy in general practice and further details will be announced in due course.’

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