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Making time in general practice

Published: 4th October 2015

This briefing paper published by the NHS Alliance and Primary Care Foundation provides recommendations for reducing workload pressures on general practice including more coordinated working between GPs and hospitals, wider use of other primary care staff, better use of technology to streamline administrative burdens, and wider system changes.

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The Making Time In General Practice study by NHS Alliance and the Primary Care Foundation was commissioned as part of the work NHS England is doing with its partners to implement the NHS Five Year Forward View, and expand and strengthen GP services and primary care across England.

The report finds that a significant amount of GP time could be freed up if family doctors were not having to spend time rearranging hospital appointments, and chasing up test results from local hospitals. This accounted for 4.5% of appointments in the study, an estimated 15 million appointments if repeated across England.

The report also estimated 1 in 6 of the patients in the study could potentially have been seen by someone else in the wider primary care team, such as clinical pharmacists, practice nurses or physician assistants, or by being supported to meet their own health needs.

Immediate practical steps to cut down on bureaucracy suggested by the report include:

  • Patients who are unable to attend a hospital appointment should be able to re-book within two weeks without going back to the GP.  Booking and rearranging hospital appointments should be simpler without the patient needing to go back to the GP;
  • Practices should employ a wider range of staff within the practice team, with the decision on the type of staff left to the discretion of individual practices and federations;
  • NHS England will work with doctors to streamline communication, particularly between hospitals and practices, and reduce the workload of processing information within practices;
  • Practices should free up time for GPs and other leaders in the practice to think through how they can work differently, learning the lessons from the PM’s Challenge Fund sites and the Vanguard sites as they become available – creating the ‘headroom’ needed to plan new ways of working and clinical innovation, and;
  • GP federations should be funded to work across their practices to build practical social prescribing projects that offer real alternatives to taking up GP time with patients whose needs can be better met by other kinds of support in the wider community.

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