Workload dump is impacting London GP practices’ ability to deliver safe patient care, the local LMC has warned.
London-wide LMC said that the number of practices whose ability to deliver safe patient care is being impacted by workload shift ‘remains high’, and that 76% are ‘unable to absorb’ that additional workload.
Of 247 practices taking part in a survey, over a third (37%) told the LMC they ‘feel pessimistic’ about being able to safely meet patient need ‘over the coming months’.
Their survey report also revealed that three quarters of practices who said workload dump is impacting their ability to deliver safe patient care, said this is due to ‘inability to absorb additional workload’, whether due to increased patient demand or ‘wider system failings’.
It comes after a report earlier this year claimed that over £4m of NHS funding is wasted on ‘interface’ issues between primary and secondary care such as workload dump.
The LMC said: ‘Responses to our most recent survey reflect the circumstances and concerns of practices responsible for a quarter of the capital’s registered patients, with the total list size of responding practices standing at 2,599,730.
‘The total list size of responding practices with vacancies is 1,062,078 – that’s at least 10% of London’s patients reliant on short staffed general practice teams.
‘Three in ten staff express concerns about meeting patent demand safely daily, whist just over a third say these concerns are expressed weekly. Fewer than one in ten say concerns are never expressed.’
And three in five practices said that current work pressures are impacting the health (mental and/or physical) of their staff.
Meanwhile, 39% of practices who responded have current vacancies they are struggling to fill, as three in five practices say perceived workload of general practice is a factor ‘preventing or hindering staff recruitment’.
The results
- Nearly two-fifths of responding practices (39%) are reporting vacancies, and those reporting a vacancy 71% are lacking at least one GP.
- The total list size of responding practices with vacancies is 1,062,078. That’s at least 10% of London’s patients reliant on short staffed general practice teams, based on a response from 22% of practices.
- Whilst nearly a million patients (924,000) are registered with a practice from which GPs plan to retire within the next three years.
- Over a third of responding practices (37%) say they feel pessimistic about being able to safely meet patient need over the coming months.
- The number of practices who say that their ability to deliver safe patient care is being impacted by workload shift remains high.
- And 76% of those practices say that they are unable to absorb that additional workload. Increased patient demand was the highest cited concern by the staff team when discussing whether how to meet patent demand safely, followed by lack of appointments and unrealistic patient expectations.
- Only 19% of practices, when asked how they feel about being able to safely meet patient need over the coming winter months, feel optimistic. Down from 24% last wave and 29% the wave before – showing a ten percent decreased in a single year.
Source: London-wide LMC
Elsewhere, Humberside LMCs have set out a comprehensive list of requests GPs should ‘decline’ and send back to hospitals, in a bid to tackle workload dump.
Pushing back against workload transfer is a key feature of the BMA’s ‘menu’ for collective action, which commenced this month.
The options for collective action, which the BMA said would not breach the core contract, include withdrawing participation in advice and guidance (A&G) and declining to use referral forms.
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Of ALL the BMA actions, this one has an immediate benefit to front line GP teams. The amount being inappropriately ‘dumped’ has gone beyond tipping point – made worse esp. by rise of virtual OPDs in secondary care. GPs are becoming the consultant’s ’clinical administrator’, often simply actioning the asks without quality clinical context AND taking unacceptable legal liabilities. e.g chasing hospital initiated investigations, uptitrating drugs whilst patient is still under secondary care, etc.
ALL LMCs need to push back dumping like Humberside. This action is most justified under the BMA recommendation action to:
“Serve notice on any voluntary services currently undertaken that plug local commissioning gaps and stop supporting the system at the expense of your business and staff”.