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GPs go forth

GP practices to send out distress signals when facing ‘unsafe’ workload pressure

GPs in Devon will be able to use a new flagging system to notify their LMC when they have reached ‘unsustainable and unsafe workload levels’.

Practices are being asked to send an ‘alert status’ to Devon LMC through a weekly report, to help the group of GPs highlight the pressures they face due to rising patient demands. 

NHS Devon CCG will also be using the information to help it decide how it can best support local practices when they experience increased pressure. 

Devon LMC chair Dr Bruce Hughes said: ‘Our innovative new reporting system will help provide robust evidence about the pressure faced by our local GP practices – and greater recognition of the scale and challenges.

‘The pressure acute hospitals are under is well publicised and is captured by the OPEL (Operational Pressures Escalation Levels) Framework. General practice has had no equivalent and so the Government, healthcare providers, commissioners and patients can sometimes assume that things are not so bad for local GP practices.’

GPs are being encouraged to complete anonymous weekly reports for the LMC, choosing from four colour-coded alert levels. A black status would indicate a GP practice is ‘in distress’, at which point it would be able to identify itself and request support from the local health system.

Red would mean it is ‘running safely under significant pressure, but requiring immediate action to relieve the burden. Conversely, green would mean the practice is running normally with adequate resources and acceptable waiting times. 

The average county-wide alert level is publicly shared on the LMC website each week. Roughly 80 GPs in the area are already submitting weekly reports to the LMC with more expected to take part as it is fully rolled out. 

Dr Hughes said: ‘This is a ground-breaking move for general practice. Devon is believed to be the first area in the country to roll out a GP alert status. Our innovative scheme has attracted interest from several other LMCs who look set to follow suit.’

Clinical chair of NHS Devon CCG Dr Paul Johnson said: ‘We know there is a link between general practice being unusually busy and subsequent pressures elsewhere within the health system, so it can serve to provide an early warning to assist other providers in better assessing and planning for future demand.’

The BMA proposed a 'black alert' system for GP practices back on 2018, which would see GPs divert or cancel all routine appointments if their workload became unsustainable.

The Royal College of GPs (RCGP) called for the wholesale introduction of distress signals for GPs already in 2015, stressing the risk burnout poses to patient safety. 

A Medical Protection Society (MPS) survey published last year revealed two-thirds of all doctors go in to work despite feeling too tired, unwell or stressed and half do not feel supported in terms of their well-being.

A version of this story was first published by Pulse sister title Management in Practice.


Readers' comments (17)

  • This is good as useless
    Unfortunately we are contractually bound to provide all primary care services regardless of how busy or short staffed we are
    Unlike hospitals who can close an A&E or outpatients due to overload we would be found in breach of contract
    Have I missed something?

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  • Our practice was on black 5 opal alert but someone DNA'd and it went to emerald 3.

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  • We are on brown alert every day,when the s+++ hit the fan at 8 am.

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  • Agree worse than useless.

    Notice they skip the response bit to unsafe alarm/flag.

    That’s because there isn’t one!

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  • Is there a feature to just set it to send a flag at 9am every morning?

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  • "Officer of the watch, what are those flares to the south east?"
    "It's the Titanic sir, White Star Line out of Liverpool"
    "Ah, they must be having a party. We don't do such stuff on the Carpathia, resume course as you were"
    "very good captain"

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  • Cobblers

    I think that there is general GP agreement that the alert status being routinely rolled out by secondary care has little effect, if any, on patient management in primary care. If they need to go in, they need to go in.

    So why in heavens name would GPs want to follow it, despite its uselessness, smacks of either desperation or stupidity.

    That being said it is fertile ground for humour and I agree that we should not follow the hospital BLACK alert. Could be considered shroud waving and unnecessarily alarmist CoVid19 and all.

    Far better the sports analogy, green (that one day in summer) , amber (standard) and red (FOIAV) flags. Hang them outside the surgery (the flags) to give ample warning to the punters.

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  • And what will happen...?
    The Square root of Foxtrot Alpha.

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  • Bob Hodges

    It aleady HAS mad a difference and proved useful......... so we're going to adopt in Gloucestershire as part of a regional effort.

    Just because you can't imagine how, it doesn't mean it hasn't.

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  • Tried it some year’s ago when having severe recruitment problems. CCG just phoned back asking us what our plan was. We needed help and received none. I don’t work there any more.

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