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BMA ‘working with DH and NHSE’ on removing bureaucratic GP work

BMA ‘working with DH and NHSE’ on removing bureaucratic GP work

The BMA is planning to ask the Department of Health to remove workload from GP practices that could be done elsewhere, in order to relieve pressures.

In an email to LMCs seen by Pulse, GPC acting chair Dr Kieran Sharrock said that the department ‘want to work with us to remove workload from practices that should or could be done elsewhere.’

Pulse understands that the BMA is now putting together a list of items to send to the Department of Health, including ‘bureaucratic items which could be done by others.’

He added: ‘There is clearly a lot of work passed inappropriately by hospital and community trusts, and we continue to work with NHSE, AoMRC, and DHSC to change this.  We also know locally LMCs are doing the same with trusts and ICBs.

‘On top of this there are various bureaucratic items which could be done by others and we want to share a list of these with DHSC.’

The list, seen by Pulse, included items such as:

  • Death certificates
  • Confirmation of death
  • Medical examiners
  • Sick notes
  • Prescribing end of life medication
  • Medication administration recording sheets (MARS)
  • Pharmacy medication switches
  • PIP forms 
  • DWP forms 
  • Community midwives/community providers
  • Get a note from your doctor “culture” – ‘GPs will not provide notes to indemnify you for an activity or to get out of something, for example gym membership, parachute jump’
  • Housing requests

As well as items GPs are funded for privately but could be removed to decrease workload, including:

  • Cremation paperwork
  • DVLA forms
  • Airlines and travel companies requesting lists of medication and conditions.

Dr Sharrock told Pulse: ‘This engagement with LMCs was to kickstart a conversation around removing bureaucracy and unnecessary workload from practices so that GPs and their teams have more time to care directly for patients – something the Government itself asked us to do to inform negotiations and discussions.

‘Ultimately, GPs and other practice staff cannot take on infinite work, and need to prioritise and focus their expertise and time on treating sick patients who need them the most.

‘At a time of huge demand and rising costs for practices, it is therefore incredibly demoralising for GPs to have a contract imposed on them that increases these pressures with no additional support.’

As part of the contract imposition this week, NHS England said there was going to be a recovery plan for general practice released in the spring.

Pulse revealed earlier this year that the recovery plan is likely to address ‘workload dump’ by trusts, although this has been promised previously.

Following the imposition of a new GP contract for the upcoming year earlier this week, which the BMA’s GPC said is ‘the result of failure to listen to what GPs actually need,’ the union said it is considering next steps and ‘all options,’ including industrial or collective action.

The contract focuses on increasing patient access, including a stipulation that GP practices offer patients an ‘assessment of need’ on first contact meaning they will ‘no longer be able to request that patients contact the practice at a later time.’

Other changes, revealed in NHS England’s letter to GPs, include the requirement for practices to offer automatic access to future patient records through the NHS app, and focussing the majority of the investment and impact fund (IIF) on patient experience of contacting their practice. 

Following the contract imposition, Dr Sharrock said that some of its requirements ‘only set practices up to fail and take GPs away from direct patient care’ and that the GPC would have ‘serious discussions’ with its membership about next steps, which could include industrial action.



Please note, only GPs are permitted to add comments to articles

Giles Elrlngton 10 March, 2023 2:06 pm

This is needed also for secondary care.

Regrettably the most annoying bureaucracy arises from appraisal and revalidation is absent from the list above.

I propose to retire before my next revalidation. Not enough doctors in UK? Fix the repetitive boring useless admin and some would work on longer.

SUBHASH BHATT 10 March, 2023 3:33 pm

Who better placed than gp to issue death certificate and sick note? Getting involved with end of life prescribing is part of primary care work.
Dvla exam , get a letter and insurance medical exam generate income for practice. None of them take long to do and not needed to be done everyday.and will not reduce work load.. copy of repeat prescription can be printed by reception to give for travel.
You need more doctors .

Dermot Ryan 10 March, 2023 3:57 pm

better still, get rid of NHSE. Talk about a waste of resources!!

Azeem Majeed 10 March, 2023 4:05 pm

I was surprised to se death certificates at the top of the BMA’s list of “bureaucratic GP work” they want to see removed. Certifying the cause of death is a core function of doctors globally. It’s also something that is laid out in legislation (unlike many of the other tasks that doctors do) and so can’t be changed easily. The BMA needs to be sensible when making these kind of suggestions.

Anuj Sean Chathley 10 March, 2023 4:12 pm

I propose that we be commissioned and reimbursed for any work do on secondary cares behalf that has been deemed secondary care contractual obligation. This should include but not limited to:

1. Issue of Med3 as not completed by secondary care when it was deemed their responsibility to do so. £ 25 per med3.
2. Emergency prescriptions as secondary care have not adhered to there contract. £ 10 per drug reviewed and issued.
3. Acting on investigations done by other providers. £ 25 per investigation.
4. Referral request by other providers.£ 25 per referral.
5. Telephone Consultation generated as a result of a breach of contractual responsibility £ 15
6. Face to face consultation generated as a result of a breach of contractual responsibility £ 25

fareed bhatti 10 March, 2023 4:39 pm

This clearly seems tinkering at the edges while not touching the core issue. Unrealistic expectations of politicians leading the public to believe (who in turn expect) they have a world class healthcare system where anything goes and general practice is an infinite resource. I find that I could live with everything else but the clinical pressures are almost impossible. While we cannot refer to or get any support from hospitals etc and are being made to toe the line with harder and harder targets. Lets increase screening programmes, lets let private healthcare run rampant doing tests and pass to GPs,more and more of stupid ‘awareness’ campaigns, lets have a million different roles who can pass on their ‘concerns’ and make GPs attend more meetings to justify their jobs , lets not plan for a rapidly ageing entitled population, and bugger the EU/ non EU recruitment streams and train GP trainees(while discouraging them all the way) in a way that is completely disconnected with real GP life.
BMA working with NHSE and DH to help GPs. Yep- its going to be a flustercluck.

Vikas Kaura 10 March, 2023 5:13 pm

@fareed bhatti, You are spot on! That sums up the plight of GPs in the UK today perfectly.

Gabor Szekely 11 March, 2023 7:38 am

Spot on, Giles Elrington. It was the approach of another revalidation with its hoops to jump through that convinced me to retire back in 2021. Also contributory was the endless cycle of largely useless “mandatory training”. Hours of unrewarding and unrewarded tripe devised by the politically-correct brigade at NHSE to give them a raison d’être! Death certificates, sickness certificates, confirmation of disability to fight on behalf of patients’ entitlements – these are indispensable parts of a GP’s rôle. The BMA really need to think carefully on what is dispensable and what is superfluous.

Scottish GP 11 March, 2023 9:14 am

Missed the target again BMA
Who in God’s name do you suggest does the death certificate?
Avoiding end of life prescriptions, what are we actually for?
Just negotiate on remuneration and let us get on with the job.

Truth Finder 11 March, 2023 9:51 am

I do not find those stressful and some things like death certification are best done by a doctor. BMA has got it all wrong. It is the time consuming safeguarding (a social worker responsibility), revalidation QoF and NHSE checks that needs targeting. The big elephant in the room is this ridiculous access when there is no staff. Get your act together BMA!

Jonathan Heatley 11 March, 2023 12:45 pm

please reduce or remove the mandatory training. It is insulting to have to do it year after year and it does not feel relevant. Letters for social services and housing and travel are also tedious.
There is a tendency for younger GPs to feel they have to get all the details on patients forward going health correct. Its as if they take over the patients responsibility, and being judged on guidelines, only reinforces this exacting and demoralising approach. Patients often take little or no responsibility themselves so we need to relax a bit. As an example a wealthy obese patient of mine managed finally to lose 2st in weight after much encouragement. I congratulated him and asked his secret- ‘easy’ he said, ‘I just took up smoking again’…

Darren Tymens 11 March, 2023 1:10 pm

This is unlikely to have much impact, some of them do not belong on that list, and sends the wrong message to NHSE and DHSC: that they can treat us badly and yet BMA will accept it and still discuss relatively trivial issues with them. They should walk away, not co-operate, define a clear interpretation of the contract including limits on the number appointments we are funded to offer – and ask us to stick to the absolute letter of it (a sort of contractor work-to-rule). Only if they are afraid of us will they stop exploiting us.

Dave Haddock 11 March, 2023 4:23 pm

Happy to do all on that list, in return for an appropriate fee.
Just keep the BMA out of any negotiations for the size of the fee.

James Weems 12 March, 2023 4:18 pm

How about ensure that hospital
Teams do the things that they are contracted to do that they frequently pass to us to do. Sick notes form hospital admissions, prescribing for their out patients, requesting tests for their patients from hospital and out patients, referring on for consultants, Chasing up hospital investigations.
THESE are the things that really annoy us.

Turn out The Lights 13 March, 2023 10:49 am

Been doing this for a decade the bureaurocratic mess has just worsened.Epic fail.

Douglas Callow 13 March, 2023 11:48 am

Appears to me GPC /Dr Sharrock is way out of his depth on this
Some of this list are so wrong and make no sense
The strategy plays further into HMG hands who will feel no pain or disruption and unlikely to move to our negotiated needs
limit daily contacts
stop 2′ care pushback
Say no to some of the dogshit stuff that adds no value
say no to prospective record access

Dave Haddock 13 March, 2023 4:42 pm

Why is Appraisal and Revalidation not on the list?
Utterly pointless and no fee.

kathryn Moore 17 March, 2023 12:19 pm

Totally agree Giles Elrlngton, I’m retiring early just before my next appraisal is due.