Managing the Load: Debate Persists Over BMA Guidelines

The BMA’s guidelines on safe working practices for GPs, published in late September, have sparked considerable debate within the healthcare community. While many have voiced support, the guidelines have also raised concerns among practice managers

CREDIT: This is an edited version of an article that originally appeared on Practice Index

The BMA’s guidance proposes a cap of 25 patient contacts per GP per day—whether by phone, online, or in person—along with a recommendation for 15-minute consultation times. This shift aims to enhance the quality of care and reduce GP burnout. The guidance also advises practices to discontinue non-contractual services, allowing greater focus on core patient care.

Although these measures aim to promote safe and sustainable workloads, some practice managers have expressed concerns about the practicality and impact of the BMA’s guidance. Many question whether it will truly make a difference, particularly as it could result in fewer available appointment slots for patients.

Strain on General Practice

The widely reported backlog of care within the NHS has added significant pressure on general practices. The BMA notes that GPs are now responsible for nearly 17% more patients than in 2015, with the average GP caring for approximately 2,295 patients. This far exceeds the 2,000-patient limit set by the 1966 Family Doctor Charter, which was introduced to manage workloads, but is now routinely surpassed.

Despite these challenges, practices are still providing record-breaking numbers of appointments to meet demand. NHS data reveals that in March 2024 alone, GP practices delivered over 29.9 million appointments, with the majority being face-to-face consultations.

What Do The BMA Guidelines Recommend? 

Offering appointments 15 minutes in length

No more than three hours of each session should be spent on consulting

Signposting to other services in the system once capacity is reached

There should be safety net plans for urgent cases

Routine appointments may need a waiting list if capacity is reached

Communicating systems to patients

Reviewing your appointment set-up if it is regularly running over

For practice managers, implementing the BMA’s guidance presents a significant challenge. While many acknowledge its importance in maintaining safe and high-quality care, concerns about longer waiting times and reduced appointment availability remain pressing issues that cannot be overlooked.