A paper commissioned by NHS employees earlier this year said training non-medical staff to do the work of doctors could be a ‘rapid solution’ to the practice workforce crisis.

On the face of it freeing up trained – and expensive – clinical staff to focus on the work that only they can do, while getting admin staff to look after more basic jobs, sounds like it could be beneficial to practices.

Indeed, a health board in Scotland agrees. NHS Ayrshire and Arran is considering retraining practice admin staff previously working on the QOF as healthcare assistants to ease GP workload.

In a report the board says ‘there is an opportunity to redesign locally to support practices to respond to the workload by utilising other professionals and allowing GPs to focus on the most complex patients.’

The report, put together after discussions with the LMC and primary care team, states that ’the removal of administration activity related to QOF’ could mean an opportunity to retrain existing admin staff to take up healthcare assistant or other caring roles. The QOF was abolished in Scotland in April 2016 with the aim of reducing bureaucracy and freeing up GP time.

Finding the time

The key for practice managers is in the point above – it’s not like admin staff have loads of spare capacity – so there’s a need to find additional man hours or free up time wherever possible.

While the ditching of QOF is undoubtedly helping in some cases, other practices have actually scrapped plans to recruit a new GP and are instead looking to cheaper admin staff.

“We had failed to recruit a suitable new GP, despite 18 months of trying,” one practice manager from south east England told us. “So, we re-evaluated job roles, spent a good few weeks working out who could perform what roles and concluded that, if we juggled roles and responsibilities, we could manage without the extra GP.

“We actually ended up recruiting a part-time junior admin person who picked up the menial admin tasks such as photocopying, invites for PPGs and the like, which freed up time for our existing staff to take on the data entry work GPs were doing. We also moved our healthcare assistants away from tasks such as supporting the nurses with immunisations, getting the admin team to look after it instead, which freed up the HCAs to further ease the workload of our GPs. A year on and it’s working well. We estimate that we’re saving about £60,000 a year by opting for this idea ahead of recruiting a GP and feedback from our PPG is more positive, especially about the levels of care we’re offering.”

The regulations

Of course, any kind of change will always have its opponents. Earlier this year, a thread on the Practice Index Forum highlighted how attempts to replace the HCA support for a nurse performing baby immunisations with admin staff caused issues within the practice.

Looking at patient group directions it’s clear that practices are well within their rights to have admin staff supporting nurses with duties, as long as a GP is on premises at the time. Many practices don’t provide any admin support to nurses at all, but they do tend to have longer appointment times, so it’s a case of working out what’s most efficient for your practice.

Feedback from practice managers on this topic suggests there are two ways to go when implementing change. There are those that say it’s time to get tough as staff will quickly get over the changes, while others feel any change of roles can only be successfully implemented by involving all staff in the decision-making process and listening to feedback. By doing that and outlining the benefits to the practice as a whole, change should become easier.

The need for creative ways of spreading practice workload will no doubt rumble on for a good while yet. But just maybe letting admin staff get on with admin could be a solution.

Could redeploying admin staff help your practice? What roles do you think they could perform? Let us know by commenting below or in the Practice Index Forum here.

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