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Target-chasing fails GPs and their patients

At a time when workload has never been greater, GPs continue to be deluged by paperwork ­ Peter Saul gives tips

Year by year the amount of paperwork GPs must deal with increases. To work efficiently and to keep stress levels to a minimum, effective strategies to cope need to be developed.

Deciding how best you work and what fits your work pattern and commitments are key starting points. Given the daily pressures and hectic schedule of most GPs, prioritising work and identifying particular points in the day or week to deal with it are key elements in paperwork management.

Prioritisation involves sorting incoming messages into three categories.

First, paperwork that involves clinical issues to do with patients. This includes pathology and X-ray reports, discharge information and clinical letters from hospital or out-of-hours provider. This needs to be dealt with on at least a daily basis and is the most important thing to prioritise.

Second, paperwork that relates to administrative things like requests for medical reports and information, practice management issues and claim forms. Urgency is less important here. This paperwork can take second place.

Third, paperwork that constitutes less time-sensitive is material relating to general information, education and health service administration. This is the least important paperwork.

Outgoing work can be similarly classified with urgent clinical issues needing immediate action, while the remainder can generally be dealt with at a more leisurely pace.

Effective sorting is the key to dealing with paperwork efficiently. For example, some material will come ready categorised, like hospital results, which are often directed straight on to the computer but quite legitimately still regarded as 'paperwork'.

Delegation is vital. GPs should not be dealing with lower-priority paperwork at all. It should be delegated to a member of the practice staff. However, staff need clear instructions, preferably written, on how to sort incoming paperwork and who in the practice deals with each category.

Different doctors may have different responsibilities, but in general as much low-grade paperwork as possible should be steered away to be actioned by management staff.

The GP must identify some slots in which to deal with paperwork. Ideally these could be programmed into the working week, but realistically many of us do it when we can, perhaps at the end of the day or in an uncommitted afternoon. Here it helps to have an effective secretary and a Dictaphone, or perhaps voice-recognition technology.

A key secretarial role involves 'nagging' the doctor when the pile of paperwork is approaching critical proportions, as well as making sure deadlines are met, typing letters and documents and filing completed work.

A period sitting with the secretary can be invaluable, allowing the doctor to direct how paperwork should be handled and further delegated. The use of electronic messaging systems within the practice can often help with GPs being able to 'task' secretarial and administrative colleagues to deal with matters as they arise.

Surviving paperwork overload involves prioritising, delegation, setting time aside on a regular basis and developing effective strategies for deciding what information needs to be kept and how, and having the courage to bin what you don't need to see or keep.

Golden rules for dealing with paperwork

·Prioritise

·Delegate

·Organise

your time

·Get good secretarial staff

·Be ruthless ­ bin unwanted mail!

Prioritisation of paperwork

·Paperwork that involves clinical issues to do with patients

This includes pathology and X-ray reports, discharge information and clinical letters from hospital or out-of-hours provider. This needs to be dealt with on at least a daily basis and is the most important thing to prioritise.

·Paperwork that relates to administrative things

This includes things like requests for medical reports and information, practice management issues and claim forms. Urgency is less important here. This paperwork can take second place.

·Paperwork that constitutes less time-sensitive material

This includes paperwork relating to general information, education and health service administration. This is the least important paperwork.

·Outgoing work can be similarly classified with urgent clinical issues needing immediate action.The remaining paperwork can generally be dealt with at a more leisurely pace.

Peter Saul

is a GP in Wrexham

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