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GPs asked to audit all 'unnecessary' appointments and paperwork

NHS England has made moves to tackle GPs’ workloads by commissioning two audits to determine the level of unnecessary appointments and bureaucracy GPs have to cope with.

It has commissioned NHS Alliance and the Primary Care Foundation to jointly manage the two audits, which are now live and are aimed at ‘identify[ing] where we can ease bureaucratic demands’ and freeing up GPs’ time to provide patient care.

The GPC has said that the audits were a positive initiative, but mapping inappropriate demand on GP time will not help unless NHS England makes real changes as a result.

The audit on unnecessary appointments asks GPs to log each patient contact, and whether it was avoidable due to reasons such as demands from other organisations, demands that could have been managed by other people and ‘demands that, if systems worked better, would not have arisen’.

Meanwhile, the survey on bureacracy asks practices to estimate how many hours they spend providing information on core contractual, QOF and enhanced services work in order to get paid, and for how many hours they spend chasing NHS England, local authorities or CCGs to reconcile payments with the work reported.

The survey also focuses on time spent processing information from hospitals, out-of-hours providers, NHS 111 and community and social services.

The Primary Care Foundation said the audits were ‘an important opportunity’ for GPs to let NHS England know about the time they spend doing unnecessary tasks.

In its invitation to practices to take part, it said: ‘As workload increases, we are increasingly aware that, as GPs, we don’t need to see everyone - that many patients could be seen by others in the practice team or by other agencies, that too many agencies make unnecessary demands on GPs’ time, or patients could find better ways to care for themselves or seek reassurance elsewhere.’

NHS Alliance said it has been commissioned to write a report on inappropriate demand, to be submitted to NHS England in May.

Dr Michael Dixon, NHS Alliance chair, said: ‘The problem is that demands in general practice have become unsustainable, and some of the demands frankly are not clinical. This is NHS England saying that things aren’t great and given this we really need to reduce pressures on general practice.’

But GPC chair Dr Chaand Nagpaul said: ‘This is a project auditing inapproprate workload on GP practices but it is not, in itself, going to reduce workload. To reduce workload we need to see tangible changes to systems of inappropriate demand on practices and we also need to see expansion of capacity.

‘It is positive that NHS England recognises that there are huge workload pressures on practices and that much of this pressure is inappropriate, but measuring this is not in itself a solution.’

Dr Robert Varnam, head of general practice development at NHS England, said: ‘GPs across the country continue to do an outstanding job of delivering care as well as driving innovation in how services are delivered locally. It’s important that we do whatever we can to support GPs to spend as much time providing high-quality care to their patients as possible.

‘That’s why we’re looking to draw on the experience and the knowledge of the primary care workforce to identify where we can ease bureaucratic demands, as well as how best some patient needs can be met without necessarily needing an appointment with their GP.’

Click here for the audit into unnecessary appointments

Click here for the survey on reducing bureacreacy

Readers' comments (31)

  • The first thing on the list will be this audit.
    The irony......wasting time doing an audit of what wastes our time!!
    And what will NHS England actually do with this information.........**** all.

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  • Vinci Ho

    (1) do it by all means but people are all sceptical and cynical about the sincerity of NHSE
    (2) irony and hypocrisy as a lot of unnecessary workloads have been created by NHSE and of course , the immaculate health SOS.
    (3) Why only now? Too predictable, mate.

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  • Does anyone remember a film called Carry On Up The Jungle.In the film they were looking for the Oozalum bird which was increasingly rare.This was because it spent so much time regarding it own backside it dissapeared up it.That is what this reads like, combined with other meaningless task to our business like the recent workforce audit(may be done)and the sepsis audit.I feel a little like one of these birds.Time to say no and give these people 2 fingers rampant!

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  • Sounds like something from 'yes minister'..anyone remember that?

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  • Wasting our time auditing 'What wastes our time' sounds like another brainwave from the wrong end. More likely it is going to be used to work out a new GP contract with shrinking money as it could be deemed as not counting for clinical time. I could be righter than I think !!!

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  • You couldn't may it up, yet somehow the ivory tower mob at NHSE have managed to pull one out the bag. again. Workload audit, sepsis audit, workforce audit, appointments audit ad infinitum..and so on...and so on. I suggest the GPC or RCGP recommends we should have one BIG, GIGANTIC FINAL audit to audit the all the audits NHSE have demanded GPs to do over the years, then once results show how pointless they are and have been to our day to day existence and how they've detracted from patient contact and care, the AUDIT TRAIL can be consigned to the dustbin of history where they truly belong.

    Disillusioned GP Partner (1.85yrs)

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  • start charging for appointments and A&E attendance: even if its £5 - 10 and most of above will get sorted

    OR come up with some sort of payment from pts which would make them think before they book an appt and take more self care without putting oneself/relative at risk. eg £100 for 5-6 primary care consultations/yr with 1 A&E attendance +/- one elective referral. beyond which further charges should apply.
    If anyone things I am being cruel: my family (kids,parents etc) and I are also pts and need some help. I have relative who currently suffer from rare illness, another one had leukaemia, 2 uncles needed CABG, etc all of them are thankful to NHS and would happily contribute. without the NHS I cannot see how anyone of them could have afforded the complex treatments they have received.

    the way we are going I only expect further rise in expectations and demands.

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  • lets think of a real solution ,charging patients wont be popular and politicians will refuse to do it .

    the only way out of this mess is to renegotiate contract.
    Every patient contact should be billed to government via computer software integrated to system 1 Emis etc like they do in canada.the rates should be agreed lifted each year as per inflation and additional payment optional for OOH or weekend work.Our contract is with Government and thats what we need to sort out .its for government and tjheir voters to decide among themselves who pays for what new taxation etc etc
    but the present set of jokers leading GPC BMA havent got the balls to do it unfortunately .

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  • Renegotiate the Contract- I agree that's the only way forward. The only problem is -Who will bell the cat?
    In Medway, some Surgeries are clambering to grab the money from PM's Challenge Fund and are happy to provide 8-8 care 7 days a week. If we are to trust a letter circulated by West Malling Health - they already have Surgeries with 70,000 patients lined up for this inititative. While majority of GPs are resisting the 8 to 8 and 7/7 openings. Sadly, the joke on Pulse by a colleague about GPs diving for a penny in front of a speeding truck is coming true.
    I think colleagues need to consider that PMs fund is a one off and is an Election lolly. What happens when it is withdrawn? Would the next generation of young GPs forgive us for digging this hole for them? Would existing GPs cope when the funding is gone and PM has moved to the US to a Pharma/Healthcare co and the NHSE bosses are sitting and having a laugh in Seychelles?
    This auditing business is another load of bull from the NHSE who have no clue how to manage the mayhem they have created and hence wierd plans and erratic behaviour surface from time to time depending how the last night with the missuses had gone. Maybe, we should just take this with a pinch of salt and just shrug it off :)

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  • Item of service payments would help focus HMG 's attention on reducing demand . Open ended contracts give them no incentive because we will always carry the can .

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