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Reaction: DH crackdown on unnecessary workload dump on practices

The Department of Health is set to introduce measures to reduce GP bureaucracy and increase patient transparancy, including:

  • Immediately stopping pointless referrals from hospitals back to GPs – a waste of time which accounts for around 2.5 per cent of appointments;
  • Introducing a single payment system that covers all transactions to stop GP practices chasing different organisations for payment;
  • Making surgeries paperless by 2018 and ending the use of fax machine communications between hospitals and surgeries will also save valuable; resources which can be given over to patient care;
  • Introducing an Ofsted-style ratings system by CCG area covering cancer, dementia, diabetes, mental health, learning disabilities and maternity.

GPC chair Dr Nagpaul said on stopping GPs having to rearrange patients’ hospital appointments: ’We think it is crucial that this happens. However it is not just missed appointments, it is a raft of bureaucratic workload shift from other sectors. Chasing up results, expediting follow-up appointments, patients coming to see us when they have had a hospital appointment but they have queries about their treatment.

’They are always being told to see their GP and it is just blocking up our appointments.’We need to put an end to GPs being left with bureaucratic workload that actually should be dealth with directly between the patient and the hospital. What we are calling for is that if a patient misses an appointment there should be a four-week window in which they should be able to call the hospital and make a new appointment. There is no need for patients to see their GP again.’   

On a single payment system: ’We have been calling for a revision of the payment system now for a while. We need to make sure that we put an end to the perversities in the current payment system which have worked against general practices and which have not recognised the transfer of workload into practices. We need a payment system which results in a reduction in bureaucracy. I don’t know the details beneath that but certainly it is something that we have been calling for for a while.’

On Ofsted-style ratings: ’We need to be careful not to create simplistic league tables of Ofsted-style ratings on matters that are quite complex. Whilst we support meaningful information to patients regarding statistics about healthcare the idea of just Ofsted ratings is a reductionist approach that detracts from looking at data in a facilitative manner.

’It creates judgements based on data that could be as much about the circumstances that differ between CCG to CCG. This is just fuelling a philosophy of reductionist league tables rather than meaningful improvement. Crude composite ratings do not create transparency.’

Dr Steve Kell, co-chair of NHS Clinical Commissioners and chair of NHS Bassetlaw CCG said: ’The secretary of state is right to move towards greater transparency and we agree that patients and local people should have more information about those who are accountable for buying local healthcare services. Bringing in expert moderation as part of the overall process should provide further reassurance to the public and patients.  The recent King’s Fund report Measuring the performance of local health systems, highlighted the complexity of the current healthcare system that CCGs work in, and therefore how difficult it is to simply rate them with an aggregate score. 

’The recommendations in that report to provide information for patients and the public at various levels of detail would offer a more rounded and realistic view of a local health system. Challenge and assurance of performance is vital but being given the support, the freedom and the flexibilities to continue to innovate, develop new models of care, and shift investment out of hospital activity will be key to a safe and sustainable future for the NHS.  

‘Relieving the NHS of unnecessary bureaucracy to be able to focus on delivering for patients can only be a good thing, and that applies as much to commissioners as it does to providers.’

Dr Michael Dixon, GP in Devon and chair of NHS Alliance, said:  ’We welcome today’s announcement. It is reassuring that action is being taken to address the views and issues of frontline clinicians, as highlight in our recent report: Making Time in General Practice.’

Dr Nav Chana, NAPC chairman, said: ’The NAPC welcomes the announcement today of measures to give patients greater power across the NHS.  “The commitment to reduce bureaucracy in general practice to release GP time is encouraging. The focus on the quality of a “system” of care for patients who share characteristics within population groups is also welcome, particularly if any rating process builds on the outcomes that matter to people.’

Justin Madders MP, Labour Party shadow health minister, said: ’Jeremy Hunt can’t claim to be giving patients greater power when on his watch patients are finding it harder to access the NHS.

’The Tories have pushed up waiting lists, plunged hospitals in to financial crisis and left patients struggling to get GP appointments.

‘The uncomfortable truth for Jeremy Hunt is that his policies are failing patients, and failing the NHS.’

Rick Stern, chief executive of NHS Alliance, and a director of Primary Care Foundation, said: ’While we welcome today’s announcements from the Secretary of State, it is important that new measures for transforming the way practices work are backed up by increased investment.

’Investing in general practice and primary care has the potential to create huge savings elsewhere in the NHS, helping to meet demanding efficiency targets, but also improving patient care.’