Safe Working in General Practice

General Practice is facing unmanageable workloads, with a rapidly shrinking and exhausted workforce. To continue to provide safe care to your patients, and to protect the wellbeing of yourselves and your teams, we urge you to take control of your workload.

This isn’t a one-off campaign, we believe that working in such a way should be viewed as ‘business as usual’ and a reset of how practices serve insurmountable demand.

April saw the launch event for our Safe Working in General Practice campaign. A copy of the Safe Working in General Practice Slide Deck can be found here along with our Issue 4 Focus On April 2023 document.

Since the GPC (BMA) guidance was published in late 2022, we have been supporting practices to take control of their workload. Practices have shared their thoughts below:

“Since implementing the safe working guidance, we feel like we can breathe again.”

“We would definitely not go back, ever!”

“Thank you for coming in again today. As you could tell, we are feeling much more positive about the current situation, thanks for all your support.”

Practice Resources

We have created a series of resources which you may wish to use to help change your ways of working.

As your LMC, we want to ensure you are fully supported in implementing any changes. We are in regular contact with the CQC, ICB and Healthwatch as well as the Secondary Care Trusts to ensured they are briefed on the campaign and aware of messaging to the general public.

The following posters can be displayed in your practice, outlining any changes you may implement:
• Assessment of Needs poster
• Patient Registrations Poster
• Safe Working Limits Poster
• Reviewing Core Services
• Overview Poster

We also have posters highlighting the different roles that make up a practice team, both clinical and wider roles.
• Meet your gp practice clinical team poster
• Meet your gp practice wider team poster

Case Study

“Our appointment system essentially evolved into a bit of a free for all whereby anyone could phone at any time between 0800-1830 and ask to be put on the ‘telephone triage list’ to speak to a GP. We had no limit on the number and so would find ourselves fighting through a never ending list of calls with no appointments to put the patients into. It wouldn’t be unusual for us to speak to more than 100 patients each day and invariably that doctor would end up seeing some of these patients too.

The time came where we just couldn’t continue this, it was unsafe for patients (and doctors) and we lost GPs because of this. Furthermore, it totally contradicts the BMA safe working guidance which the LMC have done some really helpful work on.

We therefore decided to cap our triage list at a number we felt was safe (still well in excess of the BMA recommendations) and when we reached capacity we decided to declare ourselves full (with the exception of children under 5 and any cancer/palliative care patient). We publicised this on our website and through our PPG before implementing the change and it has been really well received by our patients who have been really supportive. The telephone triage GP is still dealing with a significant number of patients but capping the number has dramatically improved the triage day which feels safer, more manageable and less stressful.”

How can we make a change?

Below are examples of ways you can make a change that still enable you to stay within the constraints of the GMS contract. We suggest that you engage and consult with your Patient Participation Group (PPG) when considering and implementing any changes.

• Move to 15 minute appointments
• Place limits on the number of appointments available per session
• Optimise patient signposting
• Place limits on the number of duty/on-call doctor requests
• Decide on maximum patient list size
• Consider practice list closure
• Check practice boundaries
• Decide if private work will continue
• Check and review all enhanced services to ensure financial viability
• Consider introducing a waiting list system for appointments
• Review PCN DES obligations

If you would like any support in implementing any changes, to discuss what changes you can make, or any further information, please contact the* liaison team* who would be happy to help.