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At the heart of general practice since 1960

Doctor leaders set to vote on introducing GP 'black alerts' when practices are full

GPs want to be able to declare a 'black alert' when their surgeries are at maximum capacity, the same way that hospitals do when they experience overfull A&E departments.

GP representatives claimed this comes as workload in UK GP practices is matched only by that in Turkey, where doctors are caring for six million Syrian refugees.

UK doctor leaders will vote on the proposals, which come as Pulse revealed GPs will have to work an extra four hours a week by 2022 to meet demand, at the BMA's Annual Representative Meeting (ARM) later this month.

One motion requests that the ARM notes 'the regular declarations of "black alert" by hospitals and demands that a similar reporting system be created for general practice to indicate that maximum safe capacity has been reached and conference instructs BMA council and the GPC to construct such a system with or without Government cooperation'.

Another suggests that 'in order to protect patients' practices should be 'enabled to self-declare a safety alert when they have reached capacity on any specific day and can then direct patients to alternative service providers such as a local hub, a walk-in centre or A&E'.

Hospitals with ‘severe capacity issues’ which declare black alerts typically ask practices not to send patients to A&E, but no equivalent option exists for GPs.

And, debating the issue at the LMCs Conference in Edinburgh last month, GP leaders suggested that this would only be possible if there was an agreed safe working limit.

Delegates highlighted that in Australia a number of 25 maximum patient contacts a day was already being used as a 'safe' benchmark.

Speaking at the conference, Shropshire LMC and European Union of General Practice (UEMO) representative Dr Mary McCarthy said: 'GPs see more patients than ever, up from 300m appointments per year five years ago to 370m appointments a year now.

'We see 40-50 patients a day and that does not include the ten fifteen telephone consultations, the home visits or the prescription queries.'

She added: 'The only other state in UEMO that has a similar workload pressure is Turkey, and that’s because they absorbed six million Syrian refugees.'

The conference decided that there should be a limit set on the number of contacts, but did not vote on what number of contacts that should be.

Dr McCarthy said: 'Anecdotally, doctors have told me they can happily deal with the first 20 patients, but after 30 they start flagging and after 40 or 50 they wonder if they’re acting safely.'

A BMA spokesperson told Pulse: ‘It is clear that general practice is under incredible and rising pressure that is impairing its ability to deliver effective, safe care to patients.

'The BMA has produced extensive guidance on how practices can within the terms of their contract reject inappropriate work being referred from other parts of the NHS which is adding an unnecessary burden on overstretched services.'

The spokesperson added that 'politicians of all parties need to use the final week of the election campaign to focus on the fundamental mismatch between stagnating resources and soaring workload that is at the root of the current crisis'.

Other GP issues up for debate at the BMA's ARM, which will take place in Bournemouth 25-29 June, are:

  • Concerns that NHS England’s new care models process is not doing enough to preserve GMS and PMS practices, and creates greater risks for partners joining large ‘pooled’ organisations;
  • That CCGs are not doing enough to enforce contractual standards preventing hospitals inappropriately dumping work on practices – as revealed by Pulse;
  • That the Government’s decision to force the NHS to pass on information about asylum seekers to the immigration officials is a breach of patient confidentiality and a risk to public health;
  • That non-clinical manager in NHS CCGs and elsewhere should be regulated in the same manner as clinicians.

Motions in full

Motion by EAST MIDLANDS REGIONAL COUNCIL:

That this meeting notes the regular declarations of “black alert” by hospitals and demands that a similar reporting system be created for general practice to indicate that maximum safe capacity has been reached and conference instructs BMA council and the GPC to construct such a system with or without government cooperation.

Motion by YORKSHIRE REGIONAL COUNCIL:

That this meeting is concerned at the increasing numbers of practices struggling to provide a safe and sustainable service and insists that in order to protect patients practices are enabled to self-declare a safety alert when they have reached capacity on any specific day and can then direct patients to alternative service providers such as a local hub, a walk-in centre or A&E.

Source: BMA

Readers' comments (7)

  • Well my place would be on black alert every day then!

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  • Many practices are akin to cattle markets with "consultations" resembling fleeting encounters with the worried well, sick note requests, social problems and trivia. Until a monetary value is placed on a GP consultation it will continue to be abused and taken for granted by the DoH, patients and all other agencies who dump on us.

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  • Cobblers

    GP Black Alerts. That'll be given the same attention as GPs should be giving to the Hospital 'Black Alert' emails. None.

    However I did note under other GP Issues this:

    That non-clinical managers in the NHS, CCGs and elsewhere should be regulated in the same manner as clinicians.

    Now THAT would be a game changer. How often have we seen extremely dubious managers being paid off and rehired within days elsewhere in the NHS at often increased salaries?

    Now if they could come under a GAC (General (NHS) Admin Council) remit, which they would pay for out of their own salaries, we could see some of these people being "Struck Off" and being prevented from working for the NHS as admin ever again.

    Now that would be an advance and would concentrate minds.

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  • All the colours would not change a thing unless the colour mean you can stop taking patients for the day. It is just generating work for more managers.

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  • Dr De'ath

    "Delegates highlighted that in Australia a number of 25 maximum patient contacts a day was already being used as a 'safe' benchmark."
    That's a single mornings work ..that's exactly the number I saw on Friday morning ..a full days 'safe' work in a single morning ..and that's considered 'normal' in my place
    ..well at least Turkey doesn't have it so easy hey poor guys

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  • Maverick

    Good morning gentlemen, the temperature is 110 degrees...
    It's the bottom of the 9th, the scores are tied, it's time for the big one...
    Goose... I want Viper....
    Viper's coming down...
    If you are a GP still working in the NHS and you are serious about saving what's left of your honour and principles then stop bickering on this website, because nobody of any influence, importance or significance gives a rat's ar*e about anything written here. Look back through the archives. Bleat, bleat, bleat...and on and on.... Nobody cares. Nobody's listening.... Posting here achieves nothing. Personally, I've already dropped my payload and done my fly by.... bust the tower and everything.
    If those of you who regularly write both eloquent and venomous comments to Pulse on this page could bring your views to those with the power of change in their grasp then there may be hope....otherwise don't bother. There's no point telling your colleagues you're pissed off when they're pissed off 'cos everyone's pissed off and nobody else gives a sh** anyway.
    Do something.... if you're that bothered...if not just leave....Play golf... I got my handicap down to scratch within six months of retiring. There is a spendidly fulfilling life away from General Practice. Look at your life and what you want to achieve for yourself and your family. Be brutally selfish. We only get one shot at this....
    It's the bottom of the 9th....

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  • This is a trap.
    Don't call a 'black alert' and you get punished for any mistakes you make when you are full, or any delays in patients you don't see or advised to attend a/e.
    Declare multiple 'black alerts' and the CCG and NHSE will come down on you with contract breaches with the 'hard man/woman' expression the middle managers love to use and practice in the mirror each morning. Unlike the Hospital Trusts however you are not too big to fail or get a bail out. They will run your business into the ground then spend millions
    on the worse performing APMS contract that replaces you.

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