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Welsh Government to take action against hospitals dumping work on GPs

The Welsh government has published guidance to prevent additional work being pushed back on GPs when they refer patients for treatment.

It comes after the BMA raised concerns that some hospital doctors have been instructing GPs to find out the test results which the hospital had ordered, which they said was unsafe.

The 11 standards include that the requesting doctor must arrange for investigations to be done and take responsibility for the results.

Onward referral of patients is also the responsibility of hospital staff and patients who contact secondary care to speed up their appointments should not be routinely advised to see their GP, the guidelines state.

GPs should not be asked to prescribe medication under shared care arrangements until formally agreed with the requesting clinician, it states.

And issuing sick notes is the responsibility of the doctor who is advising the patient to not work and certificates issued should cover the whole expected absence.

NHS England recently set up a special working group to tackle the issue of hospitals ‘dumping’ workload on GPs.

Changes to the contract between CCGs and hospitals does not seem to have made much difference, NHS England primary care director and GP Dr Arvind Madan told Pulse.

The Wales guidelines are ‘communication standards’ to clarify what roles primary and secondary care have when patients are referred.

RCGP Wales chair Dr Rebecca Payne said she was pleased to see the standards had been agreed.

‘Patients need joined up care and clearer communication is an important step towards that.

‘This document can’t be left on a shelf; hopefully it will become a valuable tool for colleagues across primary and secondary care.’

She added: ‘GPs are already working under immense pressure and it’s important that secondary care doesn’t inadvertently generate even more work for practices.

‘I look forward to the day when I no longer need to issue sick notes for post-op patients!’

Dr David Bailey, chair of the BMA’s Welsh Council said they welcomed the standards which had been developed by two health boards and approved by the BMA.

‘As such, it has positive buy in from both primary and secondary care and puts an onus on doctors in both hospital and community to make the patient journey between the two as safe and convenient as possible.

‘It's not only patient centred, we think it will also make things simpler for all doctors.’

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