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BMA checklist to manage practice workload and maintain quality

The following checklist is taken from BMA guidance to help practices manage their workload.

The BMA guidance Quality First: Managing workload to deliver safe patient care, provides a checklist for GP practices to help them manage workload.

The guidance says: Remember your prime responsibility as a GP is to provide safe and quality care to patients who need GP services as in your contract. The following checklist is to help you fulfil your contractual and professional duty of care to patients at a time of widespread demands and pressures.

  • When changing service provision in any way, you must always ensure that your practice is fulfilling the terms of its primary medical services contract and considering the needs of patients. Please contact your LMC or the BMA GP committee if you are unsure.
  • Don’t accept inappropriate referral or workload shift that is diverting you from your core duty of care to patients:
    • Write to the service provider in question if general practice has not been commissioned to do the work, and use and adapt the template letters provided with this guidance
    • Contact the CCG/area team/local authority commissioner
  • Do not take on any new non-obligatory work that is diverting you from your prime duty of care to patients which is:
    • unfunded or under-funded and therefore cannot be delivered appropriately to patients
    • not beneficial for patients
  • Review enhanced service provision. Consider ceasing involvement, after appropriate notice and evaluation of impact on patients (normally three months), in under-funded enhanced services
  • Provide appropriate information (for example in the form of posters) to ensure that patients know why changes are being made, eg inadequate capacity and a need to protect the quality of ‘core’ services or no longer being commissioned.
  • Promote self-care and appropriate use of other services where applicable, but be careful not to give patients any impression they cannot visit their local GP if they need care.
  • Review the practice’s provision of services under ‘collaborative arrangements’ and other non-NHS work, taking into account the actual cost to the practice of providing these services
  • Consider the importance and feasibility of continuing in externally appointed roles
  • Consider new systems of working or use of technology to assist workload management 
  • Consider working with other practices to alleviate workload pressures
  • If other options are not available, consider reducing the size of the practice area, or closing the practice list. This may be considered if taking on new registrants could put pressure on the practice and damage patient access to, or the quality of, the services offered. Please consult your LMC for further advice.
  • With any changes to service, ensure there is sufficient consultation with patients and always ensure you follow GMC Good Medical Practice.

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