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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)

  • Yet another reason on top of many why lots of newly qualified GPs give up their RCGP memberships. Complete waste of money unless you want a discount on a new Volvo.

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  • Welcome to the British way: this is repeated in the Police Force, Prison Service, Armed Forces.It goes something like "and in the red corner we have unreasonable expectations of you and a scapegoating policy ready for you as an individual if you fail, and in the green corner, b*gger all resources to do what you are trained to do and you must make savings because the bankers need a new yacht" . Utter cr*p. I thought we were smart. But just like the army, even though we are lions led by donkeys, we do it for our mates (patients). Sometimes I think populism is not such a bad idea: I am sad about Brexit but it gave the capuccino classes something to choke on, even if it will be self destructive in the end..

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  • "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" Another load of cr*p using the future tense. If the DOH turned up with a wheelbarrow full of money tomorrow, I'm not sure we could do anything as we are so far down the line of "nothing left".

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  • She is probably saying this because she hides in the Royal College and does not need to see any patients so it will not affect her. See how she likes going home doing 14h days.

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  • "40 simple, single-issue consultations could be akin to 10 consultations with complex patients" .....pathetic line from the spineless RCGP!!

    Every consult could potentially be complex and perhaps even land you with a manslaughter conviction....Anything and everything can walk through that door.... RCGP clearly have no idea about the day to day situations faced by GPs.

    I wonder how many patients Helen Stokes-Lampard sees/saw in her typical day at the practice!

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  • Took Early Retirement

    I was so disgusted with them that I handed back my Fellowship. I was ashamed to be anything to do with the college in the end.

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  • As a GP Trainer and RCGP member I am appalled at how the RCGP doesn't realise that it is impossible to have a full time patient facing career in NHS GP land despite them claiming it is the best job in medicine.
    They provide no tangible improvements in coal-face working and take 2 days pay off me each year for the privilege of being a member so I am eligible to train the next (shrinking) generation.

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  • please leave our holy colleagues in London alone - how would they manage without the grace and favour central London apartments, the free banquets, the expense accounts, the honoraria, the worthy conferences and important meetings with important celebs, the photo opportunities, and getting to parade around in robes and gongs in fake ceremonies?

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