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  • Scotland to expand international recruitment for doctors and nurses

    Scotland to expand international recruitment for doctors and nurses

    Friday, 22 June 2018 16:07
  • GP trainee round 1 recruitment increases 10%

    GP trainee round 1 recruitment increases 10%

    Tuesday, 19 June 2018 17:53
  • Tier 2 visa cap relaxation for doctors welcomed

    Tier 2 visa cap relaxation for doctors welcomed

    Friday, 15 June 2018 18:39
  • England will lose more than 600 general practices by 2022, predicts BMA

    England will lose more than 600 general practices by 2022, predicts BMA

    Tuesday, 12 June 2018 12:03
  • Tier 2 visa rules need ‘common sense’ overhaul, says RCGP

    Tier 2 visa rules need ‘common sense’ overhaul, says RCGP

    Wednesday, 06 June 2018 12:56

A Resized GP Image cbMarch 6 2018

The BMA is calling for safe workload level assessment to be agreed for general practice as part of a wider strategy to improve patient safety.

It’s strategy document, ‘Workload Control in General Practice Ensuring Patient Safety Through Demand Management’, contains a number of objectives:

  • agree a range of clear quantitative limits to help individuals identify what safe practice looks like for them;
  • produce guidance on the implementation of safe practice across scenarios, illustrating common practice working patterns such as telephone consultations and triage;
  • endorse or promote the implementation of system change which allows the provision of safe general practice;
  • propose contractual innovations for practices where rurality or other factors hamper system change;
  • introduce an ‘OPEL Alert’ (Operational Pressures Escalation Levels) system for use by practices and LMCs, something that is already in use in other NHS sectors.

The BMA says that there needs to be a cultural change in general practice “from one of ‘quantity overload’ amid shrinking resources to one of efficient demand and workload management.” While it calls for more to be done to attract new recruits into general practice, it also says there is a need to maintain the partnership model to protect the future of independent general practice.

In addition to improving patient safety, it hopes the strategy could improve GP morale and wellbeing, be of benefit for both practices and commissioners, and mean that locality working becomes supportive and practice-focused.

In addition, “an integrated primary care system gives general practice a stronger voice in any planning for an Accountable Care System, integrated care arrangement or similar strategic change.”

The BMA says general practice consultation rates rose by nearly 14% between 2007 and 2014 in England, while the 12 months between 2016-17 saw the total number of full-time equivalent GPs fall by 3.4%. It now wants to hear the view of GPs about its plans, and will be starting work to agree the principles around safe working levels.

“Without a recognised and realistic safe limit to individual GP workload there is no opportunity to quantify limits to the GMS contract and clearly therefore no possibility of ‘alerts’ being acceptable within the system,” says the strategy document. “Appropriate limits on workload will depend on the unique circumstances of each practice and the preferences of each individual GP, as well as the complexity of care being provided.

“There is surprising little research on ‘safe’ levels of working, although there is evidence around doctor fatigue and an increase in errors or mistakes. Limiting appointment rates, or any other rate limitation method, will require improved triage and care navigation.”

Links:
BMA 
BMA. ‘Ensuring Patient Safety Through Demand Management’. March 2 2018   

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