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BMA: GPs face ‘tsunami’ of extra work due to poor IT infrastructure in hospitals

GPs are facing a ‘tsunami’ of extra work due to a ‘lack of robust IT systems’ in secondary care, the BMA has warned.

‘Thousands’ of GPs are now taking on work that took place in hospitals prior to the coronavirus pandemic such as outpatient blood tests and prescriptions, it said. 

GPs are also having to ‘complete tests’ before making possible cancer referrals, leading to potential delays in treatment, the BMA said.

It added: ‘This is often because of a lack of digital solutions to enable hospitals doctors to do this, as well as a lack of planning for alternatives in the community.’

A new BMA survey found that half (52%) of more than 7,000 GPs said they were having to provide care that would ‘normally’ be delivered in secondary care during the pandemic.

Meanwhile, 81% had been asked to ‘carry out new investigations and manage ongoing care’ on behalf of hospitals and 74% had been asked to ‘re-refer patients who are yet to be seen in hospital’ due to coronavirus. 

One North London GP told the BMA that they were asked by local hospitals to organise blood tests in the community because hospitals ‘don’t want the patient to attend’ due to Covid-19. 

They said: ‘We have never had a commissioned community phlebotomy service and we certainly don't have one now. Our patients have to attend hospital for blood tests, so we have to write to them to explain.’

Another GP from Hertfordshire said they were concerned by CCG plans to review services after the end of the pandemic, including increasing ‘advice and treat’ pathways.

They said: ‘My concern is that as referrals will all be pushed into these categories, we as GPs will be contacted by secondary care and asked to arrange this, that and the other, and then get back to them with the results - essentially becoming House Officers to secondary care and massively increasing our workload.’

Chair of the BMA’s GP Committee Dr Richard Vautrey said that ‘rapid action’ is needed to prevent this influx of workload into primary care.

He said: ‘The NHS was always going to see a drastic increase in patient demand as Covid-19 arrived in the UK, but this crisis has truly shone a light on the lack of robust IT systems across the health service and the tsunami of extra work increasingly placed on GPs as a result.

‘This needs rapid action to deliver long-term solutions to improve the interface between secondary and primary care, and make sure we have the digital infrastructure in place to stop unnecessary prescribing, duplication of workload and extending patient pathways.’

A reduction in ‘unnecessary’ bureaucracy and regulation such as CQC inspections, as well as better digital systems and GP funding for new services are ‘desperately’ needed to prevent the NHS from ‘losing talented healthcare professionals’, he added.

The BMA’s survey also found that 31% of GPs said they are currently suffering from mental health conditions such as depression, anxiety, stress and burnout which have worsened during Covid-19.

And 80% said they will need an increased supply of face masks for staff as practices return to providing more face-to-face appointments - while 69% agreed they would need to increase supplies of face coverings for patients.

Meanwhile, a new BMA report outlines its proposals for change in general practice post-coronavirus, including reviewing GP requirements around death verification, fit notes, benefits assessments, housing and blue disability badge assessments. 

It also calls for the removal of general practice from the CQC’s remit, a simplification of GP appraisal and revalidation and a ‘step up’ in the programme of digital upgrades for practices.

It comes as NHS England announced last week that it is beginning a review into GP bureaucracy, saying that any tasks that were ‘not a good use of time’ should not be reinstated after the pandemic.

The five key recommendations in the BMA’s Trust GPs to lead report

  • Capitalise on the greater autonomy provided to general practice during the pandemic
  • There must be a significant reduction in the level of regulation within the system 
  • There must also be a significant reduction in the level of bureaucracy and duplication of information requests
  • Increase the level of digital and technological support for practices including a rapid rollout of appropriate, safe, reliable, robust and secure digital technology and consultation software
  • GPs should be empowered as clinical leaders in their communities, strengthening and resourcing the development of primary care networks and giving them the necessary flexibility to use available resources, workforce and partnerships within their area

Source: BMA - Trust GPs to lead

Readers' comments (15)

  • THIS IS WHAT LOCUMS CAN LOOK FORWARD TO-----NOW INCUMBENT GPs FINALLY GO ON THEIR POST PANDEMIC HOLIDAY

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  • It’s already here. If we’ve been crushed by a tsunami already in the past decade does another tsunami make any difference?

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  • Ivan Benett

    Please can we ban the word Tsunami’ from this sort of headline. Yes we should expect a large increase in thus far unexpressed need. But tsunami is a different order of natural tragedy that we can’t do much about.
    Sure, we should prepare for tsunamis, as Government should have done for Covid. Sure, we should react quickly, as this pandemic has shown, rather than play it down, joke about it or escape to the country.
    Certainly we should organise the tidying up process to get back to normal. It is very bad, devastating for those who lost love ones.
    Ok, maybe it is like a tsunami.

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  • many ccgs now pay GPs to do any hospital work referred back to their GP by hospitals, this should be standard practice post covid. once the money is taken out of hospital budgets - can't be paid twice - thats fraud, perhaps then a decision will be made who does what and where the money goes. You are also assuming there will be many GPs left after covid 19 to do the work. For many of my colleagues this has been the final straw and now are waiting to apply to either retire or work abroad once covid has settled and travel restrictions lifted. i think covid has shown how little respect there is for general practice and leadership from those above has been woeful. why bother anymore.

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  • They can't do blood tests, they can't issue medication, they don't want to refer to their consultant mate next door and they'll discharge you at a DNA. Double standards. Debts wiped. It is criminal.

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  • Resourced phlebotomy needs to available in every practice in the country along with direct access key aspects of hospital notes.

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  • Locally this has been a deliberate strategy. I sat and listened [and opposed] this for 5 years as a CCG director. To no end, the managers all saw this as a "smart" strategy to "save money". We have a block contract so dumping the work our way enabled them to save money off the hospital contract.
    Well intentioned GP colleagues tried to "work with" the system undermining opposition so the LMC threw in the towel. Not enough GPs were prepared to take a stand.

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  • Why have certain people been allowed to set tasks that are 'not a good use of time'? and why have certain people allowed them to be accepted?...

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  • Matthew Shaw 2:16 you’re absolutely right, it is now stated policy in so many webinars and restoration plans. GP to prepare patient for appointment, hospital 10 min chat on phone, GP to manage and refer on to next speciality. Have heard this for diabetes, cardiology, heart failure, gastroenterology, mental health, colorectal, respiratory. Only people not dumping on GP are the dermatologists who can do everything by app, and then with specialist nurse, plastics, or gen surgery to cut it out.
    It’s a Tsunami in so many ways, and will drown us metaphorically. A professor of endocrinology summed it up, ‘I think we’re all agreed that general practice needs to open up’

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  • extra work=extra money

    no xtra money=no extra work

    charge lots of money--pretend you are a lawyer--£250 an hour minimum

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