Action is needed to relieve the workload pressures on GPs
Read more about the reason GPs are taking action to hand back non funded work
This article is was written in May 2024 for Medscape and has been adapted for my new substack
As the crisis in general practice burns on, with some hope on the horizon for future contract negotiations, GP teams are still left struggling for the foreseeable with inadequate funding, forcing us to work leaner and smarter.
The problems are abundant. While the numbers of medical staff in hospitals has increased by thousands (a rise of 163% in the number of consultants over the last 25 years), GP practices have closed in their hundreds and the GP workforce has been shrinking. In September 2023 there were the equivalent of 1,910 fewer fully qualified full-time GPs than there were in 2015. Despite fewer hands on deck, demand is at a high, with an average of 1.48 million appointments being delivered in general practice per working day.
For the GPs that decide to stick around in a system that has assiduously devalued us, we are in need of help from wherever we can get it, and one huge segment of the NHS that could make a difference to our workload is the secondary care workforce.
GP’s are constantly asked to perform additional work from hospital teams for free. Every day GP’s across the UK receive letters asking us to kindly complete an array of unfunded tasks for our patients. To order and chase up bloods results; to organise further imaging; to provide fit notes; to start new medication; to refer the patient to another specialist… the list goes on. For years, the local medical committees that represent GPs have made attempts to push back against this work, but the pushback itself often generates more work and the reality on the ground is that GPs end up doing this work for the benefit of the patients. It is becoming only too clear however, that this isn’t benefiting our patients at all, since the time spent doing these admin tasks is time we are not spending with them. It has been estimated that this ‘secondary care workload dump’ is equivalent to the work of 1,150 full-time GPs, and addressing this could free up to 3 million GP appointments across England.
GPs hold NHS contracts with the government which clearly lay out the services we are resourced and commissioned to provide. Many tasks GPs are requested to follow up by hospital teams are not core work and not every practice will be commissioned to carry out ‘enhanced services’ . At present our limited resources need to focus on providing our core GP work, and taking on workload shifted to us from secondary care is putting an immense strain upon us.
GP practices were paid an average £165 per patient in 2022/2023, which is £12 less than 2018/19 when adjusted for inflation. Yet for the past decade funding for hospitals has grown twice as fast as for general practice.
Every corner of the NHS is feeling the strain right now, but nowhere as heavily as general practice. It is often said that if general practice fails, the NHS fails, and we do need help from our colleagues in secondary care to be mindful of passing work onto us that could be readily done by hospital teams.
Read it on Medscape here