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GPs asked to audit all ‘unnecessary’ appointments and paperwork



NHS England has made moves to tackle GPs’ workloads by commissioning two audits to determine the level of unnecessary appointments and bureaucracy GPs have to cope with.

It has commissioned NHS Alliance and the Primary Care Foundation to jointly manage the two audits, which are now live and are aimed at ‘identify[ing] where we can ease bureaucratic demands’ and freeing up GPs’ time to provide patient care.

The GPC has said that the audits were a positive initiative, but mapping inappropriate demand on GP time will not help unless NHS England makes real changes as a result.

The audit on unnecessary appointments asks GPs to log each patient contact, and whether it was avoidable due to reasons such as demands from other organisations, demands that could have been managed by other people and ‘demands that, if systems worked better, would not have arisen’.

Meanwhile, the survey on bureacracy asks practices to estimate how many hours they spend providing information on core contractual, QOF and enhanced services work in order to get paid, and for how many hours they spend chasing NHS England, local authorities or CCGs to reconcile payments with the work reported.

The survey also focuses on time spent processing information from hospitals, out-of-hours providers, NHS 111 and community and social services.

The Primary Care Foundation said the audits were ‘an important opportunity’ for GPs to let NHS England know about the time they spend doing unnecessary tasks.

In its invitation to practices to take part, it said: ‘As workload increases, we are increasingly aware that, as GPs, we don’t need to see everyone – that many patients could be seen by others in the practice team or by other agencies, that too many agencies make unnecessary demands on GPs’ time, or patients could find better ways to care for themselves or seek reassurance elsewhere.’

NHS Alliance said it has been commissioned to write a report on inappropriate demand, to be submitted to NHS England in May.

Dr Michael Dixon, NHS Alliance chair, said: ‘The problem is that demands in general practice have become unsustainable, and some of the demands frankly are not clinical. This is NHS England saying that things aren’t great and given this we really need to reduce pressures on general practice.’

But GPC chair Dr Chaand Nagpaul said: ‘This is a project auditing inapproprate workload on GP practices but it is not, in itself, going to reduce workload. To reduce workload we need to see tangible changes to systems of inappropriate demand on practices and we also need to see expansion of capacity.

‘It is positive that NHS England recognises that there are huge workload pressures on practices and that much of this pressure is inappropriate, but measuring this is not in itself a solution.’

Dr Robert Varnam, head of general practice development at NHS England, said: ‘GPs across the country continue to do an outstanding job of delivering care as well as driving innovation in how services are delivered locally. It’s important that we do whatever we can to support GPs to spend as much time providing high-quality care to their patients as possible.

‘That’s why we’re looking to draw on the experience and the knowledge of the primary care workforce to identify where we can ease bureaucratic demands, as well as how best some patient needs can be met without necessarily needing an appointment with their GP.’

Click here for the audit into unnecessary appointments

Click here for the survey on reducing bureacreacy