Government must recognise and pay GPs for ‘hidden workload’, says RCGP
The RCGP has called on the Government to recognise the ‘hidden workload’ GPs undertake and pay them fairly for it.
Tackling the GP workload crisis, which included a survey of 2,316 GPs, said funding ‘should reflect the full scope of GP activity, including hidden but essential work’.
The report also warned each GP in England may be losing up to £410 per day to hidden and unnecessary work created by ‘wider system inefficiencies’ rather than by ‘direct patient need’. Nearly three-quarters (73%) of GPs said this was ‘compromising patient safety’.
It said: ‘DHSC, NHSE and local commissioners should account for indirect and system-compensating work in resource allocation and contract design, guided in collaboration with the RCGP, BMA, and local GP representatives and informed by greater research.
‘Funding and commissioning arrangements should reflect the full scope of GP activity, including hidden but essential work that supports safe, continuous, and coordinated care.’
Report recommendations
Commission further research on hidden workload
Fund research to better quantify and understand hidden workload in general practice, including its drivers, variation, and impacts
Recognise hidden workload in commissioning and funding arrangements
Ensure funding and contract design reflect the full scope of GP work, including indirect and system-compensating activity.
Source: RCGP
While it argued unavoidable hidden work should be compensated properly, the report also said much hidden work ‘are tasks that do not always require a GP’s clinical expertise’ and are avoidable – averaging 25 to 30 minutes’ work per day, according to the report.
It said: ‘GPs say they are increasingly acting as a “safety net” for a fragmented NHS, spending large parts of their day dealing with administrative and system-generated follow-up work originating elsewhere in the system.
‘This includes dealing with inappropriate referral queries and redirected or rejected referrals, chasing information from other services, and navigating poorly integrated IT systems. These are tasks that do not always require a GP’s clinical expertise.’
This avoidable workload was attributed to ‘poor co-ordination’ at the primary and secondary care interface, ‘fragmented’ referral pathways, and ‘inefficient’ IT systems. GPs reported spending around a quarter (25.3%) of their time on administrative tasks that ‘related to clinical care’ but which ‘does always improve patient care or outcomes’.
Further recommendations
Publish and implement the Red Tape Challenge
Publish the full findings and require implementation across providers, aligned with professional interface guidance, with clear accountability for reducing bureaucracy, improving collaboration and ensuring meaningful reduction in unnecessary workload.
Improve provider communications and patient pathways
Introduce contractual frameworks to ensure all health and care providers provide clear, timely, and accessible communications with patients about their care, including referrals, tests, and treatments.
Co-design system and pathway reform with patients and GPs
Ensure all national system and pathway redesign initiatives are co-designed with patients and GPs and are subject to ongoing evaluation of their impact on GP workload, patient experience, and system efficiency.
Simplify and modernise regulatory and reporting requirements
Streamline incentives such as QOF and other regulatory requirements to focus on high-value care and reduce administrative burden.
Source: RCGP
College chair Professor Victoria Tzortziou Brown said GPs were ‘being asked to pick up work that should sit elsewhere in the system’.
She said: ‘GPs are routinely working beyond their hours to keep patients safe, but too much of their time is being taken up by bureaucracy and system inefficiencies that often add little value to patient care, particularly where requirements are duplicative or disproportionate.
‘From chasing referrals to navigating fragmented IT systems and complex regulatory requirements, GPs are increasingly being asked to pick up work that should sit elsewhere in the system. This is frustrating for both doctors and patients, and it reduces the time we can spend delivering direct care.
‘General practice cannot continue to act as a safety net for a system under pressure. While not all hidden workload is avoidable, a significant proportion could be reduced if systems worked better. To improve access and patient safety, we must cut unnecessary bureaucracy and design services around patients and the clinicians caring for them.’
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READERS' COMMENTS [3]
Please note, only GPs are permitted to add comments to articles
Remind me what is the current income of “PARTNERS” and why there is no vacancy for Partnership all over country ?
The job has become completely soulless. Most results I check came from somewhere else. Most medication I issue – acute or chronic – was initiated by someone else. Most referrals I make are at the behest of someone else. Most queries I answer are on the back of a consultation with someone other than me. All of these more often than not originate from noctors. The job is shite. I am nothing more than an administrator whose qualifications have been hijacked by a system wanting to do things on the cheap, putting wants over needs, capacity over quality and passing all responsibility into my hands for anything that might go wrong with that approach.
reduces the time we can spend delivering direct care-what a PC comment typical from the College. This is extra work and not our job-does it take up a consultation spot-no .Its work we end up doing for free.