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Independents' Day

RCGP does not support BMA plans for 'safe' limits on GP appointments

The RCGP has distanced itself from the BMA's suggestion that GPs should cap their daily patient consultations at a 'safe' limit, but has said that GPs need an emergency brake to alleviate pressures.

It comes as NHS England has clarified that 'arbitrary caps on patient appointments' would be an automatic breach of the GP contract.

The BMA's new guidance on GP 'black alerts', unveiled earlier this week, suggested a limit per GP of 25-35 routine consultations - or 15 complex consultations - as a recommended 'safe' limit before agreeing with CCGs to send patients on to 'overspill' clinics.

The BMA, which voted in favour of GP practice black alerts last year, has established four 'operational pressures escalation levels' similar to the system used in hospitals.

The RCGP told Pulse it supports the idea of GP black alerts but not the proposed cap on daily consultations.

A spokesperson said this was 'given how varied and diverse GP consultations can be'. 

'For example, 40 simple, single-issue consultations could be akin to 10 consultations with complex patients,' they said.

RCGP chair Professor Helen Stokes-Lampard said: 'We agree with our colleagues at the BMA that GPs need to be able to raise some sort of warning signal when things become too much – this is something that the College has been advocating for some time.'

She said this comes as 'members tell us that they are routinely working 11-hour intensive days in clinic, and then having to deal with a mountain of urgent paperwork on top'.

She said: 'This isn’t safe, for the GP or their patients... A "black alert" would be a lifeline for practice teams that are overwhelmed by demand, and allow for practices to implement emergency measures to alleviate pressures.'

Meanwhile, asked whether the plans had been approved by NHS England, BMA GP committee chair Dr Richard Vautrey suggested this was not required.

He told Pulse that this meant 'working within the existing contractual mechanisms to be able to deliver a safe and sustainable service'.

He said: 'It's in everybody's interest whether that's the local CCG, NHS England or general practice, to have a sustainable safe service. We would hope that local commissioners will work with practices to enable that to happen.'

'No right-minded thinking person would want their patients to be seen by tired, exhausted doctors.'

However an NHS England spokesperson said: 'While arbitrary caps on patient appointments would breach GPs’ contracts, we understand the pressures general practice is facing.

'That’s why the NHS is investing £2.4 bn extra in GP services, growing the number of new doctors entering general practice, and rolling out evening and weekend appointments to patients across England over this coming year.'


Readers' comments (48)

  • Vinci Ho

    As expected , but that is exactly my point that this represents a political narrative . NHSE is ignoring safety of patients . Spin it.

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  • We may be on to something. At long last the BMA have defined safe work loads and NHSE have said that they are going to disregard this. It would now be appropriate to hear from the RCGP regarding safe work loads. Then there is the GMC ‘protecting patients’. What about the King’s Fund and the Commons Health Select Committee. Then the next stage is the media. Somewhere along the way the Department of Health will try and block all of this. The problem is they also control the media. I believe creating analogies along the lines of would you be happy flying in a plane where the pilots have been working for 20 hours or more with 300 people on a poorly serviced plane that was designed to hold 220.

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  • And then hold the pilot responsible if anything goes wrong, or rather when things go wrong.

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  • I want the safest health care system in the world, put you money where your mouth is MR *unt.

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  • RCGP need to choose a side now.

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  • so basically the contract is unsafe.

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  • We know that it is probably already impossible to fund the NHS and social care to similar levels of safety as required by the CAA when flying. If not now it certainly will be in the near future, for obvious reasons.

    Consequently it would be expediant for the BMA and RCGP, along with the Kings Fund, and as many other Professional Bodies as possible, to get together to push the safety message, BUT also give the government a way out of the situation by saying that given the issues there will have to be some degree of copayment to support the services to bring them up to high standards of safety. If the Government buys it they will pay or give tax breaks for the media to influence the masses. So long as the majority of the UK populace is in agreement, it would be expedient for the Government as well. It cures the social funding issues at the same time.

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  • Investing 2.4 billion? SHOW ME THE MONEY!

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  • And that's why, thanks to Mickey, we have cake every morning.

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  • I have never regretted resigning my RCGP membership.
    Hopeless government lackeys.
    My limit is 30 with no visits and I'm beginning to think that is potentially unsafe on some days.

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