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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)

  • When did they ever ever support grassroot GPS?

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  • I am glad I am not member of USELESS RCGP. Shame on RCGP.

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  • Just add it to the list of poisonous acronyms fuelling the exodus, CQC, CCGs, GMC, NHSE, A&R, HMG, DH, PHE, PSA, RCGP

    GP RIP

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  • Little Stevie Field will be first into the gongdom anyway. Guaranteed. HSL doesn't stand a chance. What he's done to improve GP quality, eh?

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  • Vinci Ho

    Not going to write any more.
    The difference between knowing the game of politics and NOT . But would not be surprised from somebody trying to be politically correct. There were some concrete reasons why Hilary Clinton could never win the presidency......

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  • Council of Despair

    interesting that the BMA is actually sticking it's neck out on this - I fully expect them to back down but the seed of the idea of 'what is safe limits' is planted and the interesting question is why isn't the RCGP or the 'safety' watch dogs of the GMC, CQC or even NHSE interested in defining it. Think about it this way the CQC will judge you for not having the right coloured buckets in the right room but none of the quangoes want to get involved in defining safe workloads - interesting?

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  • medicine tastes awful

    Dear Professor Helen Stokes-Lampard

    It appears you r not a full-time GP, on your opinion I will not be renewing my 2018 membership.


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  • So we say we are on black alert ( most days in our practice would trigger this) What emergency measures would be available? No hub for over spill. Everyone is over booked. Nobody wants to know as the only solution is more money and more GPs. A black alert wouldn't be a lifeline at all as nobody is coming to the rescue

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  • A spokesman for the Ministry of Truth said, 'we understand the pressures that General Practice is under. Thats why we're going to make you open all evening and weekend as well as your regular 50 hour week, and then subject you to GMC jeopardy and CQC bullying if you don't. There's never been a better time to really stick the knife in. And we'll be watching out for anything that goes wrong once youve seen your 30 patients quota, and be doubly sure to persecute you. Of course if you only happen to see 29 patients in a day we'll find you in breach. In order to staff the overspill clinics we've made it illegal for you to ever retire, and by the way your pensions are toast'.
    The Royal College of Sycophancy welcomed the announcement. 'GPs are lifelong public servants, and its only right that they should pay back all the investment the taxpayer has made in them by working themselves to death' said a professor of General Practice from his university practice (closed from July to October)

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  • doctordog.

    RCGP further underlining their irrelevance.

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