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.
Practitioner
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.
- Summary: Good Medical Practice 2024 – The GMC’s Good Medical Practice guidance was updated on 30 January 2024, replacing the previous version on this date.
- Professional protection from a medical defence organisation (MDO) – MDOs still provide cover for regulatory, legal and performance management issues not covered by the Clinical Negligence Scheme for General Practice (CNSGP).
- How to safely retrospectively amend GP medical records – Amending medical records must be done carefully, with consideration for how a patient and/or regulator may view a GP’s decision to do so.
- Completion of medical reports for deprivation of liberty safeguards (DoLS) assessment – It is common to be asked to complete medical reports or assessments for our patients, any GPs look after patients in care homes with dementia and may be familiar with DoLS assessments.
Practice
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.
- Core hours contractual requirements and practice self-checklist – Practices are required to have their doors open during core hours or have a form of alternative access in place if they are not allowing patients into their premises.
- Keeping your Care Quality Commission registration up to date – It is essential that practices keep their CQC registrations correct and up to date, it is a legal requirement to be properly registered with the CQC.
- What can happen if your practice is found to be in breach of your GMS/PMS Contract – Practices served remedial or breach notices will need to take steps to remedy the issues outlined, with sanctions up to Contract termination if they do not.
- How to safely engage the services of a GP locum – GP locums form a vital part of the GP workforce – it is important that they are made welcome and can work safely at your practice.
Patient
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.
- Patient engagement resources for practice teams and PPGs – The Patient Engagement Project resource and signposting list includes links to free, practical “how to” information and toolkits on developing and sustaining PPGs, including virtual PPGs.
- Guy’s and St Thomas’ veterans guidance for GPs – Guy’s and St Thomas’ Armed Forces Veterans Network have produced these top tips for GPs.