The Government has published a new ‘bureaucracy-busting concordat’ which departments need to take into account when creating policy involving general practice.
Seven principles have been ‘developed to help reduce unnecessary bureaucracy and administrative burdens in general practice’, with input from the BMA and RCGP.
The DHSC said that the concordat – aimed at law and policy-makers as well as GP practice teams – is a ‘complementary piece of work’ to its joint review of GP bureaucracy with NHS England.
It hopes the principles will lead to:
- policy being co-designed with representatives of general practice and more proactive discussions between all government departments and the representatives of general practices to understand how changes to policy and or processes will impact them
- an increase in other professionals working in healthcare being able to complete work and requests, not just the GP
- positive response from general practice that bureaucratic burden has been reduced
The principles, published yesterday, include guidance to co-design new processes with GPs; ensuring the most appropriate professional is asked to carry out tasks; and where possible ensuring that extraction of medical evidence is automatic and built into practice systems.
Principles to reduce GP bureaucracy in full
- All policies should be designed with the patient and patient journey at the heart of the process, to ensure a minimum administrative burden for people accessing government services.
- General practice should only be required to provide evidence of a medical nature when it is unavailable by other means. Always consider why factual medical evidence or opinion is required and only request if it is absolutely necessary with as little frequency and depth as possible. Due consideration should be given to how this request for evidence should be funded if the request is made of general practice staff.
- When introducing or reviewing an existing requirement for a medical certificate or examination, ensure that the most appropriate professional for the job is able to certify, promoting alternatives to the GP, including other members of the primary care team whenever possible and appropriate.
- When requesting medical information, ensure standardised forms are available for use and ensure that all information requests are as clear and concise as possible.
- Always consider digital forms rather than paper-based approaches, with standardisation and the potential for automation or data sharing where appropriate, though digital solutions in themselves do not always reduce bureaucracy. Where possible these solutions should be integrated into general practice systems.
- When changing or designing a new process or form, ensure it has been co-designed with those who will be using it, for example GPs or other appropriate healthcare professionals, to ensure it is user friendly and supports our aim to reduce bureaucracy.
- If only medical history is required, where appropriate make provision for the option for patients to provide this themselves rather than requiring it from a GP or health professional. Where possible, this process should be designed without need for GP ratification.
Government departments who follow the concordat pledge to move to alternative pathways for gathering evidence where possible.
Departments agree to embed these principles into their policy and decision-making to enable a more effective and timely system for all.
Source: DHSC
The DHSC said: ‘Workload in general practice is high, and we all have a responsibility across Government to ensure we are not adding to this through unnecessary bureaucracy.
‘It is vital Government understands the pressures on general practice, and that additional asks should be minimised in order to prioritise time for caring for patients, including for vulnerable children and adults, and ensuring patient safety.’
It added that any requests for ‘additional work’ outside of GPs’ contractual requirements ‘should be fully resourced and balanced with their growing workloads relating to other clinical priorities’.
The DHSC said the new principles ‘signal to the sector the Government’s commitment to adhere to the principles of reducing burdens and aims to change culture across Government and improve how Government works with general practice’.
It added that less bureaucracy will free up more time for GP appointments and ‘[improve] access for all’, contributing to the Government’s commitment of 50 million more appointments in general practice every year.
It also said that the principles are hoped to ‘increase job satisfaction, retention, role attractiveness and support ambitions to grow and diversify the general practice workforce’.
The DHSC said that ‘culture change does not happen overnight and can be difficult to measure’, but that ‘over time’ it expects to see more healthcare professionals being able to complete requests rather than just GPs and a ‘positive response’ from general practice.
The DHSC and NHS England will ‘continue to engage with stakeholders to understand whether the concordat is having a real impact on GPs and gather any feedback’, it said.
Primary care minister James Morris said: ‘Since becoming minister for primary care and patient safety, one of my key priorities has been to better understand how we can help reduce the daily pressures GPs and their teams face.
‘Today we have published a new set of principles, developed with input from the British Medical Association and Royal College of Practitioners, to reduce unnecessary bureaucracy. By cutting red tape we can ensure GPs and their staff have more time to focus on providing high-quality medical care for patients.’
Former BMA GP Committee chair Dr Richard Vautrey said: ‘These principles were outlined over a year ago and their agreement now by government departments whilst welcome is long overdue.
‘All too often the default position has been to direct people unnecessarily to general practice, adding additional workload to already overloaded practices and creating needless bureaucracy for patients.
‘We urgently need the whole of government, not just the Department of Health and Social Care, to take every step possible to reduce practice workload.
‘They now need to take these principles seriously in reviewing any activity that relates to general practice to free up practices from unnecessary bureaucracy so they can focus more on patients’ needs.’
The GP bureaucracy review has previously resulted in proposals to cut GP appraisals back from five hours to 30 minutes and the allowing of death certificates to be emailed.
The NHS in England is also working on plans to allow patients to register with a GP practice online, while this summer, the fit note process was finally reformed so more healthcare professionals can issue them.
However it comes as NHS England has asked Capita to restart GP patient list cleansing, despite concerns raised by the BMA that it is a ‘bureaucratic burden’ for practices.
A version of this article was first published on our sister title Pulse.
