Secondary care providers must be ‘held to account’ to eliminate unnecessary workload dumping on practices, such as blood tests and prescribing, NHS England has said.
However, there are still no plans to further protect QOF income, after income protection ended in April.
NHS England yesterday set out measures to tackle GP bureaucracy as part of its £250m winter ‘support’ package for general practice.
The plan – which aims to improve access to GP services and ‘support’ practices – said that as part of their 2021/22 contracts, secondary care providers must ‘assess and address certain processes that generate avoidable administrative burdens for GPs’.
It added: ‘NHS England has emphasised that local system plans should hold providers to account for eliminating any unnecessary redirection of activity to general practice from other providers where this could reasonably be arranged directly by that provider, for example phlebotomy, organising investigations and, in particular, prescribing of medications.’
The transfer of patient data from secondary care to GP practices will also be improved by ‘removing the need to send email attachments or paper letters requiring manual processing’ later this year, it said.
NHS England added that it plans to ‘embed electronic fit notes in hospital systems’ from spring 2022.
It said: ‘Encouraging hospital doctors to issue fit notes to patients in their care will also further reduce the burden on GPs.’
The document reiterated plans to remove the requirement to sign fit notes in ink from April 2022 and ‘sooner if possible’ and to allow a ‘wider range of eligible professionals’ to sign them ‘at the earliest opportunity’.
The document also set out further commitments to reduce ‘administrative burdens’ related to DVLA checks and appraisals.
It said: ‘In February this year, a simplified process to renew licences for those with epilepsy and multiple sclerosis was introduced allowing patients to self-declare when there has been stability in their condition with no follow-up with their GP required.
‘DHSC is working in partnership with the DVLA to expand these changes to other conditions and is looking at opportunities to increase the range of medical professionals that are able to provide DVLA with information.’
NHS England also confirmed that annual GP appraisals – which were ‘refocused’ and ‘simplified’ in October last year – will continue in their ‘less burdensome’ format for the rest of 2021.
Meanwhile, the document also said that NHS England is ‘not intending to reopen previously agreed QOF arrangements and repurpose QOF funding to improve access, for example by substituting new practice-level access metrics such as proportion of face-to-face appointments’.
But it added that NHS England will commission a new QOF improvement model ‘focused on optimal models of access including triage and appointment type’.
It reiterated that there will be no return to QOF income protection ‘given the importance of the work that QOF incentivises, evidence of its effectiveness set out in the recent QOF review and the reduction in QOF performance during 2020/21’.
The document added that the two postponed PCN service specifications on anticipatory and personalised care will be introduced ‘no later than April 2022’.
The other two services due to launch this year – tackling CVD diagnosis and prevention and health inequalities – started this month in a ‘reduced’ form.
NHS England and the Government promised a bureaucracy review as part of the 2020/21 GP contract, but proposals have so far been met with little fanfare.
A Government consultation on reducing GP bureaucracy was published in November last year.
The ‘support’ package also said that the 20% of practices with the lowest face-face appointment levels will face ‘immediate action’, while patients will rate access to their practice in real-time.
The BMA warned that it is ‘flawed and patient care will suffer as a result’.
Meanwhile, health secretary Sajid Javid refused to meet GPs face to face and instead pulled out of appearing at the RCGP’s annual conference.