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At the heart of general practice since 1960

I've got news for the BMA – we’re always on red alert


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Fascinating to watch a radical idea evolve, isn’t it? Take the concept of capping workload, the origins of which can be traced back two years to the primordial soup that was the GPC’s Urgent Prescription for General Practice. This has now developed into a document, ‘Workload control in general practice – ensuring patient safety through demand management’.

Trouble is, my fascination has turned to incredulity. And that’s because, while full of words which are worthy, the ones this document prompts me to write include vague, muddled, unrealistic, amateurish, complete, utter, dogs and dinner.

I genuinely wanted to be impressed. Because I do want to Control Workload, Ensure Patient Safety and Manage Demand: if I do all that, there’s a glimmer of hope that I might reach the finishing line of retirement with my psyche, my soma and my medicolegal record intact.

But if this is salvation, God help us. Any sense of clarity stops with the title. Thereafter it’s a mash-up of half-baked unworkable ideas broken up by some meaningless graphics. By page six, the tone has shifted from tentative notions of appointment, hours or list size caps to an acknowledgement that workload restriction is a slippery concept best discussed in the abstract, giving the clear impression that the author is quietly trying to back out of the project.

Apparently, the papers will be interested if we’re on red alert


By the time you read about those mythical hubs – requiring ‘Sufficient recurrent funding’ and being ‘Servants of practices’ – and discover that the solution for rural practice is, get this, an ‘allowance’, you can actually hear footsteps running from a car crash.

Only when you reach the denouement about needing to define some lame-brained OPEL alert system, just like those proper doctors in hospitals have, do you realise that the whole point of this exercise is simply to give GP workload some media clout. Because, apparently, the papers will be interested if we’re on red alert.

Maybe. For one day. But my standard workload is around the 41.5 patient daily contact average recently and widely reported, and according to the BMA’s FRAX-style at-a-glance chart, that puts me firmly in the red zone. Every day. Which, by definition, isn’t news.

But let’s be fair: the Workload Control project is obviously a work in evolution. Trouble is, by the time it’s actually crawled out of the sea, we GPs will be extinct.

Dr Tony Copperfield is a GP in Essex 

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Readers' comments (5)

  • Not to mention that focusing on appointments devalues the hours each day looking at hospital letters for the medicolegal risk bombs hidden in them:

    'I'm prescribing some toxic expensive hospital medications you might not have heard of so suppose I should see the patient in 6 months. In the meantime please check her FBC in 3 in case she's about to bleed or septicise herself to death. I'll assume you will do this for me as I put it at the end of the letter. Hope you don't miss it! Ta'


    'The panel believe this young lady we have never met but you referred to us is thin and doesn't eat any normal foods but obviously isn't psychiatrically so, yet, so please review her regularly until such time as she is dangerously so then send her back to us. Don't forget to stop following her up or it's you the courts will come for! Lol CAMHS team.'

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  • Only Red, Tony? Better up your game.

    We are double black amber with a gold star or something.

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  • Vinci Ho

    Take your point the document is not clear cut and dare enough. Clearly , this demonstrates the potential fear and paranoia of NOT being politically correct in all these medical establishments without examining properly the political circumstances as we are up against this irresponsible government. This clearly explains the immediate feeble response from the chair of RCGP.
    But as I wrote last two days, it is strategic for us to open narrative(s) like ‘NHSE ignores patients’ safety’. Thanks to Pulse, we can certainly spin more with this . No surprise NHSE said ‘NO’ and used a human tape recorder to playback the typical response that the government already had invested so many billions in primary care .
    And Sara , RESPOND if you still have a conscience calling yourself a general practitioner.

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  • Fake News. "There's never been a better time to be a GP". Medical students-take note.

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  • Instead of all the utter garbage that the BMA puts out, they [ as our Union] can define safe working. Pilots do it. Do we consider ourselves superior ?
    If the BMA would look at each speciality and deine safe numbers in hours and patients or even an attempt at guidelines. Instead, they come with black widow spiders and hubs and RUBBISH, none of which is workable, because our Contract is to provide undefined, limitless GPS to the patients on our lists.
    In any case, Tony, you should be stating clearly that NO ONE should work in a system that condemns you for manslaughter if you think someone has severe dehydration with AKI, but they may have sepsis instead.
    Is it not time to go?

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