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NEWS: Practices “on the edge of viability”

NewsMany practices are “on the edge of viability” because of rising workloads and red-tape, a senior GP has warned.

Senior doctors stepped up calls for action on general practice after the latest revelations about problems in the service.

Doctors in Plymouth, Devon, spoke to a radio programme yesterday about the problems which led to mass resignations in the city last year.

Meanwhile experts today said the funding allocation model for general practice is broken – suggesting new ways to improve it.

The British Medical Association said it was time for NHS England to provide extra funding – or see the “collapse” of the service.

Speaking to Radio 4 yesterday a former Plymouth GP partner, Dr Rachel Tyler told how she completed Care Quality Commission paperwork while receiving treatment in an oncology ward.

She said partners at the former Ocean Health group faced financial pressures as well as work pressures – and feared the risk of bankruptcy.

The Ocean Health practices were taken over at the end of last year by Access Health Care, a company set up by the Devon out of hours service provider.

Devon GP Dr Mark Sanford-Wood, deputy chair of the British Medical Association’s GP committee, said: “The situation in Plymouth may be particularly intense – but it should be seen as a warning of what the rest of the country faces without urgent action to address the pressures in general practice.

“Patients are already facing unacceptable waits as doctors face unmanageable and potentially unsafe workloads, while increasingly burdensome administrative tasks mean GPs are able to spend less time on the front line delivering care to those who need it.

“The current funding settlement in general practice means most practices are operating on the edge of viability.”

Royal College of GPs chair Professor Helen Stokes-Lampard said: “Practices will only hand back their contract to the NHS as a last resort, when all other avenues have been exhausted, but distressingly, this case in Plymouth is not unique and we are hearing of similar examples right across the UK.

“We know GPs are under incredible pressure, and that this is affecting their own health and wellbeing – but it is also unsafe for patients. It isn’t good for anyone to work a 12-hour day in clinic, and then have a mountain of paperwork to do on top of that.”

•    GP funds should be allocated through a formula that includes smoking rates, patient ethnicity and Quality Outcome Framework scores, according to an article in the British Journal of General Practice today.

Dr Toqir Mukhtar, of Cambridge University, says that practice training status and numbers of GPs and nurses are also independent factors affecting consultation status – and could be included in a formula.

The researchers say their findings could also help identify high-risk practices likely to face excessive workloads..

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