The General Practice Alert System (GPAS), aimed at mapping workload pressures, is being retired as it has not had the uptake nor impact GPs had hoped for.
The Local Medical Committee began the OPEL-style mapping of general practice pressures in Devon in 2020 and has also been producing a national heatmap since 2022, in a bid to accurately reflect GP pressures.
However, Devon LMC has now said the data publication failed to generate a ‘sufficient response’ to consistent ‘amber’ alerts from the system both locally and nationally, and that in continuing to present GPAS they risk ‘normalising’ unacceptable pressures.
Data from the LMC showed that Devon has never reported county-wide ‘green’ status during the almost five years of operating GPAS.
At the end of last week, the LMC announced it has made the ‘reluctant decision to withdraw’ GPAS locally, and it has now confirmed that the national system has also been withdrawn.
Devon LMC chief executive Bob Fancy told our sister publication Pulse that the decision has been taken to stop using GPAS for three different reasons.
These were that ‘the national system needs investment, is currently inoperable and Devon LMC can no longer fund the required work’. He also said ‘there has been no interest in taking on the ownership and use of the system nationally’.
And crucially, he added that ‘locally we are concerned that we might inadvertently be helping to normalise “amber”/OPEL 3 as the routine state of general practice and that is clearly unacceptable to us’.
According to Devon LMC, during the 58 months of reporting, only the Strep A outbreak in 2022 generated a response from Devon ICB with extra support given to practices.
‘Locally, other than a significant and extremely supportive response from the system during the Strep A outbreak in December 2022 where county-wide “black” reports stimulated protective measures being introduced in Devon, and then further afield, there has been no meaningful response,’ Mr Fancy said.
Devon LMC’s update to GPs on Friday last week said: ‘Unfortunately, we have taken the reluctant decision to withdraw this reporting service.
‘Other than a single system level response during the winter 22/23, it has not stimulated sufficient response to the continuous reporting of amber/OPEL 3 over the last 4+ years.
‘Whilst not tolerated elsewhere in the system it is becoming normalised for general practice. We cannot be complicit in that when there is a mandated response for acute trusts.’
In response to the LMC’s decision, a Devon ICB spokesperson said: ‘We monitor escalation and pressure points throughout our whole system, including general practice, on a daily basis and take steps to support and implement actions that will help to mitigate and reduce pressure.’
Last year, it was revealed that NHS England had plans to incorporate general practice in the OPEL framework, which aims to standardise escalation processes for operational pressures on acute trusts and other providers.
Since then, Cornwall GP practices have been included in the OPEL framework via access to NHS England’s national dashboard.
However NHS England published a new OPEL framework for 2024 to 2025 on Monday this week which made no mention of general practice.
What is GPAS?
Devon LMC began collecting data from practices for GPAS in 2020, with the aim of creating an accurate picture of general practice resilience.
It aimed to generate system level responses to the reports in the same way as the operational pressures escalation levels (OPEL) reporting does for acute trusts.
The system was scaled up to 60 LMCs in 2022 to create a new national level report, but last year GPs said it did not work as expected and appeared to be of ‘very little value’.
Devon LMC has now revealed that only 20 LMCs regularly submitted their data, which is ‘not a large enough data sample to accurately assess national level resilience’.
A version of this article was first published by our sister title Pulse
