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Doctor leaders set to vote on introducing GP ‘black alerts’ when practices are full



GPs want to be able to declare a ‘black alert’ when their surgeries are at maximum capacity, the same way that hospitals do when they experience overfull A&E departments.

GP representatives claimed this comes as workload in UK GP practices is matched only by that in Turkey, where doctors are caring for six million Syrian refugees.

UK doctor leaders will vote on the proposals, which come as Pulse revealed GPs will have to work an extra four hours a week by 2022 to meet demand, at the BMA’s Annual Representative Meeting (ARM) later this month.

One motion requests that the ARM notes ‘the regular declarations of “black alert” by hospitals and demands that a similar reporting system be created for general practice to indicate that maximum safe capacity has been reached and conference instructs BMA council and the GPC to construct such a system with or without Government cooperation’.

Another suggests that ‘in order to protect patients’ practices should be ‘enabled to self-declare a safety alert when they have reached capacity on any specific day and can then direct patients to alternative service providers such as a local hub, a walk-in centre or A&E’.

Hospitals with ‘severe capacity issues’ which declare black alerts typically ask practices not to send patients to A&E, but no equivalent option exists for GPs.

And, debating the issue at the LMCs Conference in Edinburgh last month, GP leaders suggested that this would only be possible if there was an agreed safe working limit.

Delegates highlighted that in Australia a number of 25 maximum patient contacts a day was already being used as a ‘safe’ benchmark.

Speaking at the conference, Shropshire LMC and European Union of General Practice (UEMO) representative Dr Mary McCarthy said: ‘GPs see more patients than ever, up from 300m appointments per year five years ago to 370m appointments a year now.

‘We see 40-50 patients a day and that does not include the ten fifteen telephone consultations, the home visits or the prescription queries.’

She added: ‘The only other state in UEMO that has a similar workload pressure is Turkey, and that’s because they absorbed six million Syrian refugees.’

The conference decided that there should be a limit set on the number of contacts, but did not vote on what number of contacts that should be.

Dr McCarthy said: ‘Anecdotally, doctors have told me they can happily deal with the first 20 patients, but after 30 they start flagging and after 40 or 50 they wonder if they’re acting safely.’

A BMA spokesperson told Pulse: ‘It is clear that general practice is under incredible and rising pressure that is impairing its ability to deliver effective, safe care to patients.

‘The BMA has produced extensive guidance on how practices can within the terms of their contract reject inappropriate work being referred from other parts of the NHS which is adding an unnecessary burden on overstretched services.’

The spokesperson added that ‘politicians of all parties need to use the final week of the election campaign to focus on the fundamental mismatch between stagnating resources and soaring workload that is at the root of the current crisis’.

Other GP issues up for debate at the BMA’s ARM, which will take place in Bournemouth 25-29 June, are:

  • Concerns that NHS England’s new care models process is not doing enough to preserve GMS and PMS practices, and creates greater risks for partners joining large ‘pooled’ organisations;
  • That CCGs are not doing enough to enforce contractual standards preventing hospitals inappropriately dumping work on practices – as revealed by Pulse;
  • That the Government’s decision to force the NHS to pass on information about asylum seekers to the immigration officials is a breach of patient confidentiality and a risk to public health;
  • That non-clinical manager in NHS CCGs and elsewhere should be regulated in the same manner as clinicians.

Motions in full

Motion by EAST MIDLANDS REGIONAL COUNCIL:

That this meeting notes the regular declarations of “black alert” by hospitals and demands that a similar reporting system be created for general practice to indicate that maximum safe capacity has been reached and conference instructs BMA council and the GPC to construct such a system with or without government cooperation.

Motion by YORKSHIRE REGIONAL COUNCIL:

That this meeting is concerned at the increasing numbers of practices struggling to provide a safe and sustainable service and insists that in order to protect patients practices are enabled to self-declare a safety alert when they have reached capacity on any specific day and can then direct patients to alternative service providers such as a local hub, a walk-in centre or A&E.

Source: BMA