A new process ‘currently being evaluated’ would see GP appraisals lasting 30 minutes to cut unnecessary bureaucracy, the Department of Health and Social Care (DHSC) has announced.
The Government today published the response to its much-awaited bureaucracy consultation, including eight priority areas for action.
It follows a call for healthcare staff to submit examples of unnecessary bureaucracy, which received more than 600 responses identifying 1,000 examples, the DHSC said.
One priority area is that ‘GPs will have more time to focus on clinical work and improving patient care’, while others include ‘streamlined’ medical appraisals and ‘proportionate and intelligent’ regulation, the DHSC said.
Changes relating to its review into specific GP bureaucracy ‘will begin to be made by the end of the year’, it added.
This includes a ‘reform’ of the fit note, including ‘alternative arrangements’ for issuing the notes such as digital solutions and extending the certification to a ‘wider group of healthcare professionals’.
In 2016, a Department for Work and Pensions consultation explored the extension of fit note certification from GPs to other healthcare professionals, but this was never implemented.
It followed a vote by GPs at the BMA’s LMCs Conference that fit notes were a waste of clinical time that could otherwise be better spent.
The DHSC said that its new bureaucracy strategy will ‘lock in’ positive changes brought about by the pandemic so that GPs can ‘spend less time on paperwork and more time with their patients’.
Its consultation response said: ‘DHSC and NHSE/I have been conducting a joint review of bureaucracy in general practice. Changes will begin to be made by the end of the year and DHSC will continue to work across government and with the NHS to implement the solutions that emerge.
‘The actions will aim to boost job satisfaction, retention and role attractiveness and grow the number of doctors and primary care professionals working in general practice and Primary Care Networks.’
It added: ‘Medical appraisals must be streamlined so doctors can use the process for professional development, rather than “ticking boxes”.’
NHS England, the Academy of Medical Royal Colleges, the GMC and the BMA introduced a new streamlined appraisal process from October which takes ‘about 30 minutes to prepare’ and boasts a ‘significant reduction in supporting evidence’, the report said.
It added: ‘The Academy of Medical Royal Colleges is evaluating the effectiveness of the 2020 Appraisal model in the forthcoming 12-month appraisal cycle with NHSE/I and the responsible officers in England.
‘If the evaluation concludes that more supporting information is required for revalidation purposes, serious consideration must be given to whether organisations take on more of that burden than previously, rather than simply to pass it back to the doctor.’
The report also said that the DHSC will also work with the GMC to ‘simplify’ the international registration process, relaxing the need for GPs from outside the UK to submit up to 1,000 pages of evidence by making the process more ‘adaptable’.
And NHSX expects all areas will have ‘basic minimum’ shared care records between trusts and GP practices by September 2021, the report said.
Speaking today at the NHS Confederation’s NHS Reset Conference, health secretary Matt Hancock said: ‘Of course, rules and regulations have their place. They can be the cornerstone of safe and high-quality care.
‘But when left unchecked, rules and regulations can outgrow their original purpose – and they can stifle innovation and damage morale.’
He added: ‘You might be thinking: “Matt, I’ve heard this all before.” And on that you may well be right; and one of things we have done is gone back over the reports in this area of bureaucracy busting for the past 10 years to find recommendations that haven’t been put into action and instead put them into action where we can.
‘I’m determined that we seize this moment and build on the very best of what we have seen over these past nine months.’
In October, the health secretary praised GPs’ hard work ‘away from the public eye’ and reiterated pledges to cut bureaucracy for practices.
It followed RCGP comments that a 28% decline in bureaucracy over the pandemic had made general practice ‘a doable job’ again and BMA warnings that GPs would not be able to cope with a second wave without another pause to routine CQC inspections and QOF reporting.
In July, the BMA and RCGP joined a Government working group on ‘renewal and recovery’ in general practice, set up to feed into the bureaucracy review promised in the 2020/21 GP contract.