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We need radical ideas to cut GP workload – but not a cap on list sizes

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The latest suggestion that practices should be limited to 1,500 patients per full-time equivalent GP seems great in theory. Radical measures need to be brought in to tackle GP workload, and this is certainly a radical measure.

But the suggestion – to be debated at the Conference of England LMCs later this month – has obvious flaws. First – and most importantly – this will massively hit practice income.

Will GPs really be happy if their own union brings in a rule that will cut their funding? Who will police such a rule? Will NHS England look at their GP FTE numbers and cap their income?

Second, in the middle of a recruitment crisis, there are presumably a huge number of practices who exceed such a limit. Will they have to purge their lists, and how will they decide on the unlucky patients that are being thrown off with probably nowhere to go?

It is sad that asking GPs to ‘only’ work nine hour days may just be too radical

And how about those practices that have expended huge effort in adapting their skill mix to alleviate their recruitment problems. Will we tell them that no, that restructure that enabled them to stay afloat is no longer acceptable?

In my opinion, it is a non-starter. But I have sympathy with Shropshire LMC, which proposed the motion – presumably to start a conversation.

Because they are starting a conversation, and their other suggestion – that we cut the working hours to 8am to 6:00pm – may just work. But why stop there – how about a working day of 9am to 6pm? Sadly, it is an indictment of the perception of GPs that asking them to ‘only’ work nine hour days may just be too radical.

Jaimie Kaffash is editor Pulse. You can follow him on Twitter @jkaffash