General Practice Alert State (GPAS) rollout information

  • Safety

Practices who have signed up to GPAS need to complete a few simple steps once a week to contribute vital data for showing the pressures on general practice.

Colleagues at Devon LMC have developed a simple system which collects a small amount of anonymised data from practices to show the broader system the strain general practice is under in Devon. This presents data in a simple to understand format comparable to OPEL data. They have now developed their system to convert the GPAS data into an OPEL assessment with associated triggers for a system response to support.

Londonwide LMCs and other LMCs across the country are working together as part of a national roll-out. If your practice is not yet signed up to GPAS you can find details of how to join here.

What does this mean for you? Once a week we will ask you to provide us with five pieces of information, as follows:

1. What is your alert status?GREEN – practice running normally.
AMBER – sustainable in the medium term only and management action is required to revert the practice to green state.
RED – sustainable in the short term only.
Black – unsafe to continue without intervention from stakeholders
2. What is your locality?
3. What is your PCN?
4. How many patient contacts did you have on Monday?
5. What is your list size?

Finally, if you have assessed your practice at alert state red or black and want support, please email GPSupport@lmc.org.uk.

The data we collect is entirely anonymous and will be used to state the case for general practice at system level. In effect we will be creating a narrative so that system partners can no longer say that we have no detailed information from primary care. This is a strategic tool and whilst there is a system response protocol you will not necessarily see immediate benefit at practice level. However over time, it will be immensely valuable. Devon has been running the system for two years and the data is now an integral part of system dashboards, and it has changed system thinking.

GPAS will become increasingly difficult to ignore as it gets rolled out across the country and ultimately LMCs.

Monday appointment activity communication

The GPAS data collection includes total Monday appointment activity.

We ask that you submit data, for all clinical appointments to include all doctors, nurses, HCAs/HCSWs, and pharmacists that have taken place on a Monday. This may also include your extended access appointments.

Along with your raw list size we will then be able to track activity per 1000 patients at borough and ICS levels providing more evidence of pressures in general practice. Clinicians working in the acute environment are likely to have a much better sense of the challenges facing general practice when figures presented as per 1000 patients or average list size are used.

We are aware that this does not include your administrative workload, however, clinical workload displayed as a trend will allow us to demonstrate the changing general practice activity levels to the wider healthcare system. This will be of particular importance as activity levels rise over the coming months.

This data remains entirely anonymous, and we will report by Londonwide LMCs, ICS area and borough only.

GPAS open

Every Tuesday, at 09:00, Londonwide LMCs will send the following email to notify practices that GPAS is open for their input:

“This week’s GPAS is open for your input. The form can be accessed directly and completed using this link (your contact will insert the link to your LMC GPAS Data Collection Microsoft Form).”

GPAS reminder

Every Wednesday, at 09:00, Londonwide LMCs will send the following email to practice that GPAS is open for their input. In this reminder, we include the percentage of practices that have responded so far, an early indication of the GPAS/OPEL conversation status, and the average contact response for Londonwide practices.

“This week’s GPAS is open for your input. The form can be accessed directly and completed using this link (your contact will insert the link to your LMC GPAS Data Collection Microsoft Form).
Below for ease of reference is the GPAS guide

Alert state GREEN overview

The GREEN state references a practice running normally with resources largely in balance, patient waiting times are acceptable and communications with external stakeholders are at routine levels. The Green state is sustainable in the long term.

Key assessment criteria are:

Patient flowDemand being met with waiting times at an acceptable level
Staff levelsBalanced and sustainable
CommunicationsAt routine levels with stakeholders

Alert state AMBER overview

The AMBER state references a practice running with some staff/resource shortage, patient waiting times are acceptable and communications with external stakeholders are at slightly elevated levels. The amber state is sustainable in the medium term only; management action is required to revert to the green state.

Key assessment criteria are:

Patient flowWaiting times extended but tolerable
Staff levelsSome shortages but tolerable in the medium term
CommunicationsIncreased level of communications with some stakeholders

Alert state RED overview

The RED state references a practice running safely under significant pressure but requiring immediate action to mitigate the situation. Staff shortages, increased patient waiting times and elevated levels of communications with stakeholders will have put the whole practice under tenable strain. The red state is sustainable only in the short term.

Key assessment criteria are:

Patient flowCompromised with insufficient bookable appointments and telephony possibly overwhelmed
Staff levelsShortages impacting upon operational delivery
CommunicationsImmediate communications required with stakeholders

Alert state BLACK overview

The BLACK state references a practice in distress. This state is unsafe to continue without intervention from stakeholders.

Key assessment criteria are:

Three assessment criteria at alert state RED
No ability to revert to AMBER or GREEN in the short term

Next is how to access the appoint report for the GAS return depending on whether you are SystmOne or EMIS.

Accessing the appointment report for the GPAS return in SystmOne

Click on ‘Reporting’.
Click ‘Appointment Reports’.
Then click ‘Appointment Report’.
Set the from and to dates to the Monday that you are reporting on.
Click ‘Run Report’.
The ‘Number of appointments’ column is the number of contacts to be reported.

Monday contacts data extraction – a step-by-step guide for EMIS practices

Step 1: Go to your appointment book and click the sixth tab across ‘General Practice Workload Tool’. Your screen will look a bit like this.
Step 2: Change the range by choosing the day you wish to report as both the from and to dates, then hit ‘Apply’.
Step 3: Look across to the Utilisation and DNA rates section, looking for the ‘% Utilisation”’.
Underneath it is ‘Booked Appointments’ – the number here is the number you want to report for GPAS.