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BMA calls for maximum number of patients per GP

Enable 15-minute or longer appointments to be routinely available for complex cases

Louise Prime

Thursday, 14 April 2016

A national standard must be set for the maximum number of patients that GPs, nurses and other primary care professionals can reasonably deal with to ensure that a safe and high quality service is maintained, the BMA has insisted. In its latest report Urgent prescription for general practice, it said there is a significant and growing gap between the demand placed upon general practice and its capacity, and it calls for a series of measures to be taken urgently, at both national and local level, to address the increasing and unprecedented pressures that general practice faces.

The BMA pointed out in the report that the proportion of NHS funding spent on general practice has fallen from 10.4% in 2005/6 to 7.4% in 2014/15, leaving practices receiving an average of only £141 per patient per year – equivalent to an effective funding deficit for general practice of at least £2.5bn.

It said there is “no single magic bullet to address the many issues facing general practice” and that significant and multifaceted actions are clearly needed to resolve the current crisis – primarily by Government, NHS England and clinical commissioning croups (CCGs), but also by practices and GPs, and supported by Local Medical Committees (LMCs) and the BMA GPs Committee (GPC). These would include both an immediate ‘rescue package’, and long-term action to provide a sustainable, viable and vibrant future for general practice.

The BMA highlights in its report how GP consultation rates and numbers have dramatically increased as many patients’ needs have become much more complex, with many patients being less confident to manage self-limiting conditions. In addition, it said, rising amounts of work have moved from secondary care to general practice, “often inappropriate and unfunded”, increasing the bureaucratic burden on practices and practitioners.

It called for a reduction in workload “to ensure delivery of safe and high quality care with a national standard for a maximum number of patients that GPs, nurses and other primary care professionals can reasonably deal with within a working day and greater clarity about what work is appropriate to be delivered by practices”.

The BMA said GPs and other practice team members should be enabled to routinely offer consultations of 15 minutes or longer where necessary for patients with greater needs such as complex or multiple morbidity – even though this could result in a waiting list for routine appointments, in the interests of patient safety.

Other key areas that the BMA said must be addressed to turn around the current crisis facing general practice are:

  •  Fair and sustainable funding and resources to reach a minimum of 11% of NHS spend to cover the work of general practice and to resolve the funding deficit of around £2.5bn
  • An expanded workforce, both within and around the practice
  • Reducing the regulatory burden of the Care Quality Commission (CQC) to prevent time and resource being taken away from service provision
  • Reducing bureaucracy and duplication to empower professionals and to give more time to meet the needs of patients
  • Empowering patients to give them confidence to manage their care and to free up GPs’ time for those who need it most
  • Infrastructure and technology to deliver practice and system resilience to ensure that practices are able to deliver the services needed.

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