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The Royal College of GPs is calling for the implementation of a ‘safety alert’ system in general practice to protect patients and the teams who care for them.
Professor Kamila Hawthorne, Chair of the RCGP, says the system is designed to send out a warning when surgeries are running over maximum capacity, so that local healthcare systems can step in and offer support.
She says it will help GP practices to “sound the alarm and call for help before the care of patients is compromised.”
Non-urgent to be deprioritised to preserve patient safety
The new system would see GPs temporarily suspend some non-priority activities such as routine check-us, staff training and non-urgent paperwork, so that patient safety can be reprioritised.
This would work in a similar way to the Operational Pressures Escalation Levels (OPEL) system which is used in hospitals to monitor and manage the pressure on its services, and would mirror a similar flexibility given to GPs during the Covid pandemic.
This would enable Integrated Care Systems to work with practices to determine which activities can be temporarily and safely suspended.
Professor Hawthorne says ‘overflow hubs’ could also be set up to support practices which are overrun at peak times, and allow for additional funding for locum cover.
GP to patient ratio now stands at an average of one GP to 2,300 patients
The calls come following the latest RCGP survey of more than 1,500 members, which found that nearly half of GPs (46%) said they did not have enough time in their appointments to ensure patient safety.
This is particularly pronounced in London, where there is the highest fully-qualified GP to patient ratio, at one GP to 2,537 patients (the average ratio is one GP to 2,300 patients).
Here, and in other areas of central and East England, 60% of GPs say they do not have enough time to adequately assess and treat patients during appointments.
Professor Hawthorne is also calling to cut down on bureaucracy and paperwork, after the survey found that half of GPs say a quarter of their workload is taken up by unnecessary work, while one in five (19%) said nearly half their time was spent doing such work.
General practice has “none of the mechanisms” that other safety critical professions have
The RCGP says the findings are further evidence of the College’s concerns over escalating workloads and rising demand for GP services.
Indeed, the profession is experiencing serious staffing shortages, which the RCGP says can be attributed to ‘years of under-investment and poor workforce planning by successive governments.’
Indeed, GPs are now carrying out 150,000 extra appointments each day, with 883 fewer GPs compared to 2019.
Professor Hawthorne says: “General practice is a safety critical industry yet GPs have none of the mechanisms that other safety critical professions, such as the air traffic industry, have in place to protect them.
“Our number one priority is the safety of our patients, but GPs are doing more and more to try and meet the rising demand for our services. When you’re fatigued, you’re more likely to make mistakes and our survey shows that many GPs are no longer able to guarantee that the care they are providing to their patients is as safe as it could be.”
General practice has been “run into the ground”
Prof Hawthorne says while some GP appointments are brief and routine, most “require careful consideration” and “should not be rushed”.
Despite this, general practice is often overlooked by the government when it comes to support and funding, she says, and now, work will need to be done to compensate for these “years of neglect.”
“As well as recruiting thousands more trainees, we need a fully-funded national retention scheme to support our experienced GPs to remain on the frontline of patient care and measures to reduce the amount of time that we have to spend on unnecessary paperwork when we could be spending it with our patients.
“General practice is being run into the ground and we need action to stop this, for the sake of our patients, our GPs and their teams and the wider NHS,” she said.