Workload crisis drives GPs to demand power to close lists and drop home visits

Local Medical Committees (LMCs) will set out major concerns over practice workload later this month, highlighting worries over the impact of pensions tax and medicines shortages – and calling for practices to be able to close their lists unilaterally and drop home visits

This is an edited version of an article first published by GPonline.

GP leaders at the 2019 English LMCs conference on 22 November will also demand a public apology from NHS England – accusing it of having ‘knowingly brought general practice into disrepute’ with a report earlier this year that suggested practices defraud the NHS out of £88m a year.

LMCs will debate a motion deploring ‘failures to find workable solutions to the NHS pension crisis’, and demand ‘immediate action’ by the BMA’s GP committee to produce advice specifically tailored to general practice on pensions – ‘including information on withdrawal from the NHS pension scheme entirely’.

Delegates at the conference will also call for compensation from Primary Care Support England – the service outsourced to private provider Capita over its handling of NHS pensions and delays in replies to complaints and queries by GPs.

But in a major indicator of the current pressure on general practice, doctors will debate calls for a ‘separate acute service for urgent visits’ to be established, with ‘the anachronism of home visits’ to be removed from practices’ core contract responsibilities. LMCs will demand powers for practices to close their lists unilaterally – arguing that ‘commissioner approval should not be required’ for practices to close their lists for up to 12 months over a two-year period.

GP workload

GP leaders will also call for ‘urgent action with regard to medication shortages’ – warning that the lack of availability of drugs has hit practice workload. GPonline reported earlier this year that more than 100 drugs prescribed in primary care are currently out of stock – driving up practice workload and potentially putting patients at risk.

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Serious concerns over emerging primary care networks will be debated, with representatives set to warn that the organisations will not ease pressure on primary care and setting out concerns over funding for staff they are intended to recruit.

LMCs will warn that hospitals are continuing to add to pressure on general practice through ‘flagrant continued contravention of the standard hospital contract’.

GP leaders will call on the BMA’s GP committee to carry out an audit of ‘unresourced work that should be done elsewhere’, and for a mechanism to transfer funding to general practice when hospitals breach rules around transfer of workload.

GMS contract

GPs will also voice concern over the lack of advance notice for practices ahead of the five-year GP contract implemented earlier this year, in a debate warning that ‘final contracts must be provided at least six weeks prior to the commencement of that contract’ in future.

The BMA has warned that the NHS is heading for its worst winter on record – with GPs expecting a major knock-on impact from cuts to hospital capacity as the majority of doctors reduce their working hours to avoid pension tax penalties.

GPonline revealed last month that practice workload had increased significantly in the first half of the current financial year, with practices delivering 2.7m more appointments than in the same six-month period a year earlier.

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