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Making time in GP practices

A better use of time and GP appointments?Last weekend, Prime Minister David Cameron cited a report by the Department of Health that claimed 1 in 4 GP appointments are potentially avoidable and that it’s time to cut bureaucracy in practices – all based on a report practice managers contributed to.

The Making Time In General Practice study by NHS Alliance and the Primary Care Foundation was commissioned as part of the work NHS England is doing with its partners to implement the NHS Five Year Forward View, and expand and strengthen GP services and primary care across England. The report was overseen by a steering group including the RCGP and the BMA GPs’ Committee and included an audit of 5,128 GP appointments across England and a survey of 250 practice managers.

The report argues that a significant amount of GP time could be freed up if family doctors were not having to spend time rearranging hospital appointments, and chasing up test results from local hospitals. This accounted for 4.5% of appointments in the study, an estimated 15 million appointments if repeated across England.

Spread resources & cut bureaucracy

The report estimates that 1 in 6 of the patients in the study could potentially have been seen by someone else in the wider primary care team, such as clinical pharmacists, practice nurses or physician assistants, or by being supported to meet their own health needs.

The study also adds something that practice managers have been saying for many a year – that the reduction of bureaucracy in general practice should be made a national priority; freeing up time for practices to work together, improving communication between general practice and hospitals, unlocking the potential for the whole system to work together, as well as supporting changes and improvements within individual practices. In particular the report calls for streamlined payment systems that GPs use, to simplify and speed up how much time practice managers spend on entering data.

Immediate practical steps to cut down on bureaucracy suggested by the report include:

  • Patients who are unable to attend a hospital appointment should be able to re-book within two weeks without going back to the GP.  Booking and rearranging hospital appointments should be simpler without the patient needing to go back to the GP;
  • Practices should employ a wider range of staff within the practice team, with the decision on the type of staff left to the discretion of individual practices and federations;
  • NHS England will work with doctors to streamline communication, particularly between hospitals and practices, and reduce the workload of processing information within practices;
  • Practices should free up time for GPs and other leaders in the practice to think through how they can work differently, learning the lessons from the PM’s Challenge Fund sites and the Vanguard sites as they become available – creating the ‘headroom’ needed to plan new ways of working and clinical innovation, and;
  • GP federations should be funded to work across their practices to build practical social prescribing projects that offer real alternatives to taking up GP time with patients whose needs can be better met by other kinds of support in the wider community.

Dr Jonathan Serjeant, GP, co-director and co-founder of Brighton and Hove Integrated Care Service and national lead for NHS Alliance’s Accelerate programme, argues that, using today’s IT, patients should be given more control over their own patient records rather than this burden staying with GPs. He said: “GPs and their colleagues are experts in listening, supporting and diagnosing their patients. This is what we’ve been trained to do, and what we want to do. If applied quickly, the recommendations set out in this report, particularly those around extending the GP team to incorporate other health professionals, will help reduce the current levels of bureaucracy GPs face on a daily basis. The end result is that GP time is freed up, and people have access to all their information whenever they need it.”

Dr Robert Varnam, head of general practice development for NHS England, said: “General practice is the bedrock of healthcare and NHS England commissioned this report because we are determined to support GPs in reducing the pressures they face. The findings include helpful suggestions which should free GPs to spend more time with patients most in need and further ways to reduce the administrative burden.”

What do you think of the headline findings of this report? Do you welcome the opportunity for PMs to contribute to surveys such as this? Please let us know your thoughts below or by commenting in the Practice Index Forum here

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One Response to “Making time in GP practices”
  1. Linda Says:

    Has any thought been given to indemnity insurance for all these other posts? We have a meds waste management worker. One of his roles is supposed to be aiding compliance with medication – but I cannot get indemnity for him – all I get told is he would be covered by Drs indemnity so long as he worked under very tight parameters. It is not clear to me exactly why Drs indemnity costs should continue to rise to cover all/any of these possible alternative posts.

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