Exclusive An LMC has advised practices to switch off their online consultation systems ‘at a minimum’ outside core hours and consider disabling them during core hours as a response to ‘unmanageable and unsafe workload’.
Surrey and Sussex LMC sent advice to practices in response to the imposed GP contract, which requires GP practices to offer an ‘appropriate’ response to patients the first time they get in contact, which will include ‘communicating with the patient’ or directing them to appropriate services from 15 May.
The LMC said that the new contractual requirement may lead to appointments being booked ‘two to three months’ in advance, adding that the current system does not enough resources to provide a quicker safe service.
After the contact imposition by NHS England, the BMA expressed concerns around the new requirement, saying it believes it ‘is not achievable for many practices with current resource and workforce.’
Dr Julius Parker, chief executive of Surrey and Sussex LMC, said it is now time for GPs to ‘take the initiative’ and ‘determine their response to their unmanageable and unsafe workload’, in the guidance issued to practices last week.
The LMC advised all practices should switch off their online consultation systems, at a minimum outside core hours (from 6.30pm to 8.00am on weekdays, and from 6.30pm on Fridays to 8.00am on Mondays) but practices should consider whether demand and capacity constraints mean their on-line platform should be switched off during part of core hours too.
The LMC also recommended all practices implement the BMA’s advice on safe working, and suggested they should:
• Institute 15-minute appointments [longer if clinically appropriate] and
• Limit the total number of appointments per GP to between 25 to 35 each day, this includes telephone and on-line appointments.
• Move away from an unlimited ‘duty doctor’ system: there may still be a ‘duty doctor’ whose available appointments are capped in number but are only bookable ‘on the day’.
On switching off online consultations, Dr Parker said: ‘The LMC recommends practices do this in a predictable and published way, or it may be confusing to patients, rather than at variable times during the day.
‘It may be that practices now have to create much longer periods of appointment availability, extending perhaps, two to three months into the future; this would be regarded as very prompt in terms of specialist waiting times.’
Depending on the functionality of the practice’s IT system, the LMC recommended they either create a waiting list, or have longer waiting times at which appointments can be booked.
Patients should be advised these are based on the availability of doctors, nurses, and other clinical colleagues within the practice.
Dr Parker said: ‘Although it is not the general practice I and most colleagues hoped for, it is now time to accept the NHS general practice that colleagues would want to provide will never be adequately funded by NHS England.
‘Instead, GPs should deliver the service NHS England is resourcing, and this is one with a limited capacity.
‘Patients will need to start to access other services instead of general practice, and accept that only a limited service is available, with a waiting list introduced to see a GP and other practice-based colleagues.’