Managing Workload
Consensus on the Kent and Medway Primary Secondary Care Interface
BMA Guidance on inappropriate workload : Practices have no contractual obligation to undertake this work and should pass requests back to the provider. The BMA have provided template letters to help GP practices push back on inappropriate workload from ICBs, prescribers, hospitals and your area team. Many practices already have protocols in place to do this.
Private Provider Requests to GPs for Investigations under the NHS
Advice for GPs for requests to prescribe sedative prior to dental procedures
Proforma Rejection Template letter - July 2024
We have had numerous queries to the LMC regarding referrals being rejected by providers, if not done on their preferred proforma, website or tick box form. There is no obligation for referrals to be done in this way and a standard referral letter, ensuring required information is included, is sufficient. Please find a link above to a BMA letter template to respond to any of these, inappropriate, administrative rejections.
BMA Focus on Proformas and referral forms
This guidance has been written as part of a suite of resources to support LMCs, Practices and GPs in taking back control of workload and reducing bureaucracy. GPC England is focusing on any supposed requirement to use referral forms or proforma where there is no advantage for either the GP or the patient in doing so.
We are often asked the question about providing low dose sedatives for patients attending a hospital appointment for imaging. Please see attached communication for your use which we hope you will find helpful.
Information on prescriptions issued after a private consultation
For Information from NHS Kent & Medway explaining to patients why GPs may not provide an NHS FP10 prescription following a private consultation please click HERE. For a printable leaflet please click HERE
Kent & Medway ICB Position Statement on Mixing Private and NHS Treatment
To make sure that the NHS remains free at the point of delivery and access to NHS services is based on clinical need, but not an individual's ability to pay, guidance (Guidance on NHS patients who wish to pay for additional private care (publishing.service.gov.uk)) states that the NHS should never subsidise private care with public money. Click on the heading above to read the full statement.
DoH Guidance: Bureaucracy busting concordat: principles to reduce unnecessary bureaucracy and administrative burdens on general practice
In 2020, the government committed to jointly reviewing bureaucracy in general practice, alongside NHS England (NHSE), with the intention of reducing the burden on GPs and teams and releasing more time for care. Click on the link above to read the full document.
Raising Concerns - Primary to Secondary Care Interface - email addresses have been established for reporting breaches of the interface standards for both hospital and community contracts.
List Management: LMC In Touch Extract 2015
BMA Guidance: Prescribing over-the-counter medicines in nurseries and schools - GPs are often asked to prescribe over-the-counter medication to satisfy nurseries and schools. This is a misuse of GP time, and is not necessary.
BMA Guidance: Controlling workload in general practice strategy - Workload is, arguably, the most important factor in managing working conditions for GPs nationally. The BMA proposed a workload control strategy to address the factors involved.
Managing Workload - Requests for School Certificates
Shared Care
The following excerpt regarding Shared Care is from the BMA's Prescribing in General Practice, published April 2018 (click here to access full version of the document)
"Sometimes the care of a patient is shared between the two doctors, usually a GP and a specialist. There should be a formalised written agreement/protocol setting out the position of each, to which both parties have willingly agreed, which is known as a ‘shared care agreement’.
It is important that patients are involved in decisions to share care and are clear about what arrangements are in place to ensure safe prescribing. In some cases, a GP may decline to participate in a shared care agreement if he or she considers it to be inappropriate. In such circumstances the consultant would take full responsibility for prescribing and any necessary monitoring. Guidance covering these issues (Responsibility for prescribing between primary and secondary/tertiary care) was published in 2018 on the NHS England website" (click here to access NHS England's website).
Fitness to Fly During Pregnancy
Issuing fitness-to-fly certificates during pregnancy is not provided by the NHS, including services from midwives, consultant obstetricians, and GPs.
If you require a fitness-to-fly certificate, you will need to contact a registered private health provider. You can find one by searching for ‘fitness to fly certificate in pregnancy’ online.
For further information on air travel during pregnancy, please look at the Royal College of Obstetricians and Gynaecologists (RCOG) leaflet : RCOG Air Travel During Pregnancy Guide