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Local GP leaders demand renegotiated contract with safe working limits


PCN breach notices over enhanced access GP cover 'unlikely' due to 'ambiguous' contract


LMC leaders have voted in favour of a motion demanding that the BMA renegotiate GMS contracts across the UK ‘with workload limits’.

The motion said the GP Committees of England, Wales, Scotland and Northern Ireland should ‘use data on safe workload’ as the basis of their negotiating position.

It said this was necessary ‘in order to protect all general practice staff and patients’.

In all, 70% of delegates at the UK LMCs Conference voted in favour of the motion, with 24% voting against and the remainder abstaining.

Proposing the motion, Cleveland LMC secretary Dr Rachel McMahon said the pressure on GPs is ‘inhuman’ and the workload ‘intolerable’.

She said: ‘I think we just don’t realise how bad it is, we’ve become accustomed to it.’

She said that if it is not put into the contract, ‘people will continue to feel that they cannot say no’ to workload.

Speaking in favour of the motion, Morecambe Bay GP Dr Michael Price said ‘resilience’ is an ‘overused term within the NHS’ and that it is a ‘proxy for inadequate resourcing, and for poor workforce planning’.

He said that ‘the only responsible, true and meaningful wellbeing initiative’ is to ‘reduce GP workload’.

Speaking against the motion, Dr John Ip of Glasgow LMC said that putting a ceiling on workload is ‘not professionalism’ but ‘being dictated to’.

He said: ‘What might have started off as a safety mechanism will turn into another thumb screw on practices that has the potential to get tighter and tighter with each successive iteration of the contract.’

But Cambridgeshire LMC’s Dr Paula Newton said that workload limits must be embedded into the contract ‘before it is too late’.

She said: ‘Primary care, the often unrecognised foundation of the NHS, is crumbling in plain sight. When we collapse, we will take the rest of the NHS with us, and this is perilously close to happening.’

The BMA developed an OPEL black alert system in 2018, which suggested a cap of 25-35 routine appointments per day to ensure a ‘safe’ workload for GP practices, however this was never recognised by NHS England and it was unclear how GP practices could put it into practice.

Meanwhile, BMA guidance on safe working published in March encouraged GPs to ‘consider’ opting out of the PCN DES, and said practices could also consider closing their list to new patients.

RCGP president Professor Dame Clare Gerada said at Pulse Live London earlier this month that GPs need to start ‘saying no’ to work in order to tackle the workload crisis.

Motion in full:

AGENDA COMMITTEE TO BE PROPOSED BY CLEVELAND: That conference, with regards to current workload within general practice:

(i) believes that patient safety is paramount – PASSED

(ii) recognises that reducing the number of patient contacts will have an impact on access – PASSED

(iii) calls on GPC UK to coordinate the creation of credible agreed workload measures that are acceptable to the profession and to the wider NHS – PASSED

(iv) calls on GPC UK to further develop, publicise and strongly advocate worked-up plans to introduce safe workload limits for general practice that do not constitute a breach of contract – PASSED

(v) calls on the GPCs to use data on safe workload to renegotiate the GMS contracts with workload limits in order to protect all general practice staff and patients. – PASSED

Source: BMA

READERS' COMMENTS [2]

Patrufini Duffy 10 May, 2022 1:41 pm

There is nothing specific in any motion – mere generic adjectives and adverbs; which is why nothing changes. You cannot even define General Practice in 2022 – what even is it in the UK? The utter re-direction you are facing, whilst private companies are setting up around you to take the cream off, leaves you only with the underfunded complexity and loneliness and clinical negligence risks – all at a nice capped fixed rate – unlimited contact and social care included: which seems like a great prospect to new trainees. They aren’t going to sign up to that. Laughable – keep signing up. But, here start with these 2 very simple changes – it might put a smile on the entire profession – but will seem like you are moving a planet to achieve it. And if you can’t achieve it, it means NO ONE cares what you think or feel – whether evidence based or not, and you are just being fleeced for your blah blah altruism (clap clap).

Idea 1: CPD: 20 hours required. Stop colleague and patient feedback.
Idea 2: End to Victorian-aged home visits – tariff fees applicable only.

Andrew Jackson 10 May, 2022 4:41 pm

‘The BMA developed an OPEL black alert system in 2018, which suggested a cap of 25-35 routine appointments per day to ensure a ‘safe’ workload for GP practices’
Not sure that this level is a safe sustainable workload!