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GPs surveyed on willingness to withdraw patient services

The GPC is asking GPs to consider what services they would be willing to withdraw in a bid to reduce their workload.

A national survey of GP members, which closes Sunday midnight, asks GPs whether they would consider 'restricting clinical work to contractual essential services' while increasing 'the use of external referral for non-core services'.

The options also include withdrawing from 'wider non-contractual services that GPs voluntarily provide', as well as the QOF.

The survey, which marks the next step following the GPC's decision not to ballot members on their willingness to submit mass resignations, further suggests GPs might temporarily suspend new patient registrations or apply to reduce practice boundaries and 'remove patients from the list'.

The GPC announced that in August that it will not ballot members on potentially submitting undated resignations or industrial action after claiming that it has won concessions on workload from NHS England.

According to the GPC, NHS England agreed to take on board a number of suggestions from the GPC’sUrgent Prescription for General Practice’, including ensuring GPs work within safe limits and longer appointments.

At the time it said that instead of a ballot, it would be ’surveying members... asking grassroots GPs for their views on future negotiations with the Government’.

Survey question on withdrawing services

Which of the following would you consider doing in order to safely manage practice workload? Choose all that apply.

a. I don’t need to take any further measures to manage workload

b. Restricting clinical work to contractual essential services, and increased use of external referral for non-core services (eg phlebotomy, ECGs, spirometry being carried out at a local hospital)

c. Working at scale (eg super-practices, MCPs, federations)

d. Withdrawal of wider non-contractual services that GPs voluntarily provide

e. Withdrawal from additional services, such as the provision of contraceptive services

f. Withdrawal from enhanced services, such as the provision for minor surgery, extended hours

g. Withdrawal from the quality and outcomes framework

h. Temporary suspension of new patient registrations

i. Application to reduce practice boundary and remove patients from the list

j. Withdrawal from local CCG meetings and activities

k. Other (please specify in 100 words)

Source: BMA

Other questions in the survey focus on GPs' hopes for the future model of general practice, how they want to receive funding and charging overseas patients.

The GPC's next step comes as Pulse has learned that some GPs are disillusioned with the measures taken by the GPC to save general practice in crisis.

GPC chair Dr Chaand Nagpaul said he urges all GPs to respond to the 'vital questions' in the survey 'at a time when general practice is facing unprecedented pressures'.

He said: 'We want to hear from all GPs - newly qualified, well-embedded in general practice, or at the tail end of their career; whether a partner, salaried, locum, trainee or any other type of GP.

'This survey is crucial for informing national GPC policy and negotiations, and to design the future of general practice based upon the needs and aspirations of grassroots GPs.'

The next step in place of mass resignations

The GPC has told Pulse that legal advice and feedback from GPs contributed to the decision to drop plans to ballot the profession on industrial action.

Although some LMC leaders expressed concern at the decision at the time, in light of the overwhelming vote in support at May's LMC conference to take the 'nuclear option'.

Meanwhile, as revealed last week, LMC leaders are plotting their own 'plan Bs' for general practice in their areas, including looking at charging patients directly for services.

They are inspired by the Northern Irish GPC, which is currently investigating the willingness of their GPs to exit the NHS and deal directly with patients instead.

Meanwhile, GPs in Lincolnshire are already refusing non-contractual work as part of an LMC-led campaign.

Readers' comments (19)

  • Bring it...
    1) Ear Syringing
    2) ECG
    3) 24hr BP
    4) All shared-care prescribing where a LES is not in place, including any monitoring & recall
    5) Doppler outside of DVT services
    6) Spirometry

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  • Home visits. Straight off the bat, there I said it.I should either be in the surgery or out on the road. I cant be in two places at once. Hospital consultants don't make house calls between clinics why should I? It should be a separate service completely like district nurses.

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  • Ooh I have more
    1) sick notes
    2) Private referral letters
    3) Dental problems
    4)Letters from secondary care saying GP to chase...
    5) Emergency contraception (Why is it my problem that somebody doesn't want or cant afford morning after pill
    6) prescriptions for gulten free food ( why cant they get a voucher??)
    7) Any and all request for OTC medications (again subsidies and voucher system would be fairer)

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  • survey of whom - I have not seen it?

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  • Has anybody received the survey/ questionnaires . I haven't. How are these surveys done? Who decides who gets questionnaire ?

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  • To reduce GP workload it will be necessary to teach the patients, when young, how to look after their own health. Diet and exercise are paramount considerations. Get them books on low sugar diets, and superfoods diets. Advise them not to consume too much animal fats. In the past centuries when we walked to work at the Farm or in the Factory, it did not matter so much what we ate. If we now drive to a sedentary job it does matter what we eat. Less calories, more vitamins and minerals. Also advise moderation in alcohol consumption - excess drinking can as good as pickle one's liver. Teach them how to maintain good composure to reduce the risk of suicidal ideation. Get them kitted out for life to look after their own health and happiness as far as possible. This could reduce the demand from people unhappy with their lives and health.

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  • it's just another survey of opinion and will be ignored.

    the purpose of it is to make it look as though something is being done.

    it will be followed by a wonderful speech with facts and figures about how bad things are and so many GPs are going to pull out of this or that. But crucially there will be no actual action.

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  • how do I get the survey? Or are they just asking their GPC mates?

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  • Chaand is very good at surveys. He recently wrote to me at the double whammy of something. He has been surveying and moaning and complaining.

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  • This survey and any outcome to reduce services is playing into the hands of this government, which, as we well know, is itching to kick the privatisation can, to the end of the road and kick the NHS into the gutter.
    Private companies will pick up the ever increasing slack and your practice will be at risk of being reduced in size, or eventually closed.
    Please take back control and fight to save the NHS, along with your hospital colleagues and 'Health campaigns together'.

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