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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)

  • It was like this before covid

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  • "In NI, the reset of the NHS will be led by primary care"
    officials still think there are unfathomed endless resources in primary care just waiting to do every body else's work.
    Guess what?
    The well has run dry.

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  • We, at Tri-PCN Alliance of Waltham Forest London, have discussed this matter and unanimously agreed not to entertain such requests from hospitals.
    Practices will respond by return emails to hospitals to arrange proposed investigations and/or prescriptions at hospital end.

    Our LMC is also supportive and robust in this matter.

    The Alliance's document on this subject was published in Pulse on 12 June, titled
    " PCNs' Proposals on Re-establishing GP Services after Covid-19", highlighting in details practices facing additional 'psunami' of workload, huge patient demands, enormous back log, mental health issues, post-covid complications, patient education, IT upgrades,
    practice finances and so on.
    Below is the link for reference.
    I think this is must-read document.

    Pulse also publishes Alliance's related news story on 11 June, " Restoring GP services will cost practices £6,000 a week".

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  • "The beatings will continue until morale improves..."

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  • Hospitals could send blood form and prescription directly if all practices had properly funded community phlebotomy services.Also why can’t cardiology arrange their own echo and holster monitor?
    Remember it’s also the GP having to contact the patient to tell them what the hospital has suggested,writing a script and checking allergies etc as the gp has medicolegal prescribing responsibility for counselling patient on side effects, drug monitoring, follow up etc. For blood tests we can’t order Many specialist blood tests as a GP in most cases, in addition, it is extra time in getting the result of a blood test back back, filing and auctioning it if it is abnormal and reading back to recall what it’s for and then having to forward the result back to a hospital PA so the consultant knows it has been done. Also patients want it done urgently.
    If this work isn’t going to be just dropped on top of everything else then we should insist on a phone appointment for CQC safety reasons for prescribing counselling and to manage safe workload .If we develop a 3 month outpatient processing appointment waiting time or are sending Clinically urgent overflow to AE then perhaps they will look at more efficient ways of working like sending out their own script and blood form.

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