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Gold, incentives and meh

How can you reduce your workload?

Give us your ideas to help make GPs’ working lives easier

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wow campaign logo 3x2

An appeal from the Editor

nigel praities square

nigel praities square

Dear Pulse reader,

How many times can we say it? General practice can’t cope.

The endless line of punters at the door every day; a full list before you even look at the ‘extras’ or the home visit requests. It is not quite a war zone out there, but after a Monday morning surgery it sure can feel that way.

GPs are known for their resourcefulness, but right now it is impossible to find any headroom to think through the problems. The profession needs immediate help, but the cavalry is not coming, or at least it won’t be here until 2020 if you believe the GP Forward View.

This is why Pulse has launched a War on Workload this month. We want to gather all those clever little ideas that you use in your practice and publish them so others can follow your example.

They can be as small as a poster on how antibiotics don’t help colds, or as radical as a complete ban on home visits to care homes unless there is an immediate medical need. Please take five minutes to send them to us and we will collect them together to produce a manual for all practices to share. We hope, with your help, to make a seismic difference to the workload that practices have to deal with and help keep everyone’s head above water.

I hope that is a ‘forward view’ all GPs can get behind.

Best wishes,

Nigel Praities

What are we looking for?

Ideally something that costs very little, and could be applied by any GP practice, large or small, such as:

Template letters that you use to bat work back to secondary care.

Practice policies that reverse-engineer workload dump from care homes, hospitals and others.

Educational materials for patients that enable them to self-care when required.

Systems you have in place to ensure that urgent care appointments truly are used for emergencies only.

What should I do?

Please fill in the form below via the link or write to us with a short description of your idea. Just a few sentences would be fine, although please do send any supporting materials if you have them to hand – to  

Click here to fill out the form

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Readers' comments (29)

  • Administrative burdens and Compulsory 'Training' have proliferated ++ over last few years. While no one can argue that training isn't a good thing, the burden is now unmanageable.
    Someone could draw up a list of this stuff, decide and prioritise that which is really necessary and pay us for our time doing it. Eg BLS is essential but some other items are too prescriptive, should be optional and demands for certification de professionalise doctors who historically read up on things and addressed their own learning needs.
    Examples include;
    Spirometry, ecg, cervical cytology (when we have been doing smears for years!) IG, safeguarding(important but every year?) fire safety, health and safety, employment law, etc.
    All this along with mounds of documentation for CQC not to mention commissioning work means a day a week for many GP partners.
    And, let Care Plans be used judiciously for complex patients rather than a count up exercise.

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  • With friends like RCP NICE saying 'don't ignore simple illness such as sore throat as it might be SEPSIS' who needs enemies! Such rot! This has set back any attempt to get patients to manage simple illnesses themselves 10 years.
    One reason we are swamped is that the threshold for requesting an urgent GP Appointment is already way lower than years ago without this additional stoking up demand.
    As a GP of 30+ years I guess the number of patients I have seen with sepsis:patients with self limiting or treatable infections = 1:5000.

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  • We need the BMA to insist on an immediate change to our contract.It must be obvious to everyone- doctors, patients,BMA, RCGP and the government that this 'as much as you want ' contract with a finite resource is impossible to fulfil.
    If they want to continue this provision, then they need to alter our contract to only make us responsible for what is humanly possible.
    If we are to provide a limitless service then they need to acknowledge there will be mistakes made as a GP cannot know everything and even if they did they couldnt provide this service with no time.
    Our contract should have a maximum number of patient contacts a day, less contacts the more complicated the case .If we have to take more time because of problems contacting secondary care and social services, then this should also be the governments problem and not ours.
    How the government fills the gaps is their business. .

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  • just locum

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  • When a hospital consultant asks me to do a referral for him/her to another consultant I start letters like this:

    Dear consultant X,
    Consultant Y has seen and assessed this patient and would like them seen by you and for some reason asked me to write the letter on his/her behalf.....

    If you can't beat the system at least mitigate the misery of secondary care dumping by writing sarcastic letters.

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  • Restore the rights of the GP to become a family physician, and individualize care based on clinical conditions (symptoms-examination-diagnosis)., and abolish or at least go slow on screening. Is it really necessary to offer a PSA to a nice 92 year old gentleman?

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  • Dear friends
    All your suggestions are impractical Read your contract and phone the BMA.

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  • Russell Thorpe

    Move your afternoon surgeries later. A long lunchtime removes time pressures and you can relax knowing you will always get a break between surgeries.
    Do as much as you can for your colleagues all the time. Medicine is a team event. If everyone followed this mantra a large amount of work load would evaporate overnight.

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  • Our independent contractor status will be phased out within 5 years.stupidly the government think GPS are not worth the money they earn. So while we are independent we should start saying no and be more self preserving. Our sanity demands it.

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