Safe working in general practice

  • Safety

This page gathers resources covering practitioner, practice and patient safety because we know that the current pressures are increasing risks in all these areas.

Anyone working in general practice sees the mismatch between demand and workforce capacity, and the major impact of this discrepancy on safe patient care and GP and practice staff retention. Doctors work in a safety-critical sector (on a par with aviation, railway industry etc). The product of the health sector is health care of quality – a human product.

Our most recent workforce survey has data on GP practices concerns about their ability to provide safe care and we are now one year on from our report: Retention in London general practice, published last April, which highlights how workforce shortages are impacting safe practice.

The current core contract was heavily driven by the political promise to increase the number of appointments in general practice with prioritisation of quick easy access and meeting ‘want’ conveniently. In the context of too few GPs and nurses, this has been at the expense of providing safe care to all and effective care to those with greatest need, and has further exacerbated the untenability of the clinician working day.


If you feel that you are struggling with your work and may be becoming unsafe you can contact our GP Professional Support Network, who provide peer-to-peer support and access to experienced professionals who can help with a range of issues. In most cases seeking help when you are first concerned something may be going wrong is the best approach, rather than waiting until you reach crisis point.


Practices can contribute to Londonwide LMCs’ understanding of the pressures they are under via the General Practice Alert State reporting system. This involves providing a short, weekly data return which provides real-time data for us to advocate on your behalf, in a similar way to the OPEL system used by hospitals. Practices who are facing difficulties can get help via our GP Support team.


Practices have to meet the reasonable needs of their patients and engage with them to determine whether this is being met. Clearly, unsafe care due to untenable workloads does not meet reasonable need, and therefore there is a need to engage with patients to seek their views about how practices use their finite and very limited clinical time.