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‘Historic opportunity’ for GPs to be trusted to do their job, says RCGP

The Government should take the ‘historic’ opportunity of the Covid-19 pandemic aftermath to move to a regulation regime which places more trust in GPs, the RCGP has said.

Its new report on general practice after the pandemic said a ‘better balance has to be struck’ to give GPs sufficient time for clinical consultations, while identifying ‘the minority of practices’ which may need regulators’ attention.

It argues that general practice has shown during the pandemic response how well it functions when there is less bureaucracy to wade through.

The report said: ‘The Covid-19 pandemic has the potential to change general practice radically and permanently. Across the UK, practice teams have had to reconfigure their operating model overnight. The pace of change has demonstrated the remarkable adaptability of general practice.

‘Now, as we start to transition towards a “new normal”, we have an historic opportunity to embed or accelerate those changes which have been for the better, while discarding those which are detrimental to the profession, to the NHS and to the communities we serve.’

Moving forward, ‘a better balance needs to be struck between giving GPs sufficient time for clinical consultations while also assuring the safety and quality of patient care’, the RCGP argued.

This should see ‘inspection systems which are intelligence-led and based on proportionality, and that focus on the minority of practices which may need regular monitoring and support to improve’.

The report said: ‘At present, we have low trust-high regulation regimes. We need to shift the dial towards greater trust in professionals.’

RCGP chair Professor Martin Marshall said: ‘While we recognise that regulation has a place in general practice, the fact is that 95% of GP practices are rated good or outstanding.

‘Making GPs and our teams go through box-ticking exercises has little patient benefit and isn’t the best use of our time, especially as we deal with the expected surge in clinical workload in the aftermath of Covid-19.

‘We are asking the Governments in all four nations to make changes to ensure we can spend more time with patients.’

The report echoes calls made by Professor Marshall as he appeared before the House of Commons Health and Social Care Committee in May, when he praised a ‘dramatic reduction in administrative tasks’ not seen for a decade.

BMA GP Committee chair Dr Richard Vautrey has also urged the Government to ‘reflect very carefully’ before reintroducing GP bureaucracy, while other GP leaders have requested a prolonged pause to CQC inspections.

NHS England said that aspects of bureaucracy that were a ‘poor use of time’ should not be reinstated, as it launched the review of GP bureaucracy that was promised in the 2020/21 GP contract agreement last month.

What the RCGP is asking for

  • The introduction of new approaches to intelligence-led monitoring of the quality and safety of care, minimising the administrative requirements on practices particularly in countries which have low-trust systems of assurance;
  • Contractual requirements, such as QOF and QAIF, to focus on high-trust approaches to assuring or improving quality with low administrative requirements;
  • The implementation of a new yearly appraisal system across the UK, minimising pre-appraisal documentation and the administrative burden on GPs and focussed on wellbeing, reflective practice and development; 
  • The rapid review of requirements for returning GPs to reduce the administrative requirements for getting GPs back into the workforce, including retaining them on medical performers lists for longer with greater flexibility, underpinned by further investment to support and incentivise their return.

Source: RCGP’s report ‘General practice in the post Covid world’, 7 July 2020


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