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It's time to say 'no' to unresourced work - here's how

From Dr Farah Jameel

The recently published Kings Fund report tells us that the number of consultations (face ­to ­face and telephone) has increased by 15% over the past five years, three times the rate of increase in the number of GPs. There has been a 63% growth in telephone consultations, contributing to stressful and highly pressurised working days for GPs.

We suffer from self martyritis

Avon LMC carried out a survey of its practices in 2015 to measure the flow of unresourced work being passed from secondary care into primary care. 77 practices responded over four weeks and the LMC received 3,267 examples of this unresourced work. On average they each took 10 minutes or more, that’s 545 hours worth of work provided for free.

The General Practice Forward View dedicated ten pages to workload, clearly articulating the need to release capacity within general practice with 27% potentially avoidable GP appointments.

But how many of you have put your foot down and said ‘no this is not my job­ I will not do it’? We suffer from self martyritis and until we learn to say no our workload is just going to continue exponentially increasing.

One solution GPC chair Dr Chaand Nagpaul mentioned at the LMCs conference is the GPC document Quality First. We have now launched new interactive pages on the BMA website which gives you practical tools and guidance to tackle workload. We have created templates for you to use to send work that is not your responsibility back to where it belongs - these templates are in word, pdf, EMIS web, SystmOne.

We have provided you with lists of enhanced services that you may be providing for free, to help you negotiate funding, we have provided guidance on fees for letters that are not your core contractual responsibility.

GPC has equipped and empowered you with the tools you need. Use the guidance, discuss it at your practice, at your LMC, negotiate with your CCG and get the services you are already providing appropriately funded. This is general practice awakening and pushing back unresourced work.

If you’d like to write to Pulse email


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Readers' comments (5)

  • cool

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  • The real issue is that we are so busy. It takes time to look at the demands in a letter from a hospital department or from a patient and to assess whether that is part of our core general practice or not. Many issues are very grey. Then if we do decide that it is not within our contract we go through the process of letting others know, refusing to do it, potentially creating anger and alarm from patients and hospital doctors. It is often easier and takes less time to just carry out the request. The last thing that GPs want Is conflict with either patients or hospital colleagues.... The job is just so stressful already!

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  • It would be far easier if we charged for everything that we did. It would also curtail demand to a certain extent. So long as we were being paid at an appropriate rate per consultation we would never have any problems finding exra clinicians if the demand increased.

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  • Farah....... saying "no" will only make them make you say "yes".........

    its actually time to


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  • I've been a GP for 25 years and leaders always say" no unresouced work" but we still do it!!!

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