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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)

  • This might be an opportune moment for a long-overdue campaign from the BMA for all GPs to resign from that self-perpetuating oligarchy known as the RCGP. Decimate their funding and see them wither and die.
    Doing the same for the GMC would be more difficult legally but an at least equally appealing concept.

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  • This approach is not going to retain RCGP members is it?

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  • Can anyone give me one seriously good reason to be a member of the RCGP? If anyone is reading this please ask yourself what you are achieving by paying its subscription fees? HSL is not going save General Practice.... she merely produces feeble soundbites from the sidelines whilst front line GPs are left at their own peril dealing with unsafe workloads. We need an alternate choice, not this monopoly. Use the savings for your own escape plan.

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  • 509£ per year to support this?

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  • So RCGP members read this
    They know that HSL won’t see this amount of patients per week, coz she’s too busy doing important stuff
    But she dosent care about you doing in, with the risk to your from doing so.

    So why are you paying her? I don’t get it.

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  • Are we better than Pilots ? Their Union defines safe working. It is as simple as that.
    Otherwise doctors are abused. Witness Dr BG, covering 3 other doctors at times. I have done routinely 80 hour weekends with 3/4 hours of sleep. I have on 2 occasions, been single handed in a 3 SHO unit; once for 3 and the other for 6 months without a single hour off.
    These are the rota gaps of the 70/80s.
    The BLAME lies squarely with the BMA.
    They come up with rubbish, such as 15 minute appointments [ passed at ARM], without changing the number of appointments.
    Pilots do it, lorry drivers do it. They DEFINE safe working. The BMA does not.
    Are they for doctors or for the Govt.?

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  • And this is why I cancelled my RCGP membership the day I qualified. Best decision I made and saving me £100’s a year!

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  • Macdonald’s medicine - all what I can see you get for your college membership at £500/year, is to be able to write MRCGP after your name.

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  • There’s an important and rather cynical difference between us and pilots. A pilot’s mistake can kill 350+ people in one NEWSWORTHY incident. And inquiries are set up to find out why and limit work shifts, regulate rest periods and the line.
    But if as many patients get hurt or die as a result of unsafe workloads being imposed on GPs, then it just seeps out at the end of local TV news, if at all. Apart from when the odd poor doctor gets hung, drawn and quartered, of course.

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  • Dear Name and address - if you write MRCGP with the year you passed the exam in brackets is there anything they can do to stop you writing it anyway? e.g. MRCGP (2013).. you are merely indicating that you passed the exam in that year, not that you are a current member. Im not too bothered as Ive got my Australian letters to use instead anyway..... would just be nice to remind them of their loss of influence

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