Lincolnshire General Practices are participating in 'safer working' to protect the future of primary care.
Use the buttons below to access guidance and resources to support you and your practice to take action.
Summary of 'safer working' actions, what they mean and how you undertake them
Full Document here: BMA-GP-Practice-Survival-Toolkit-Summary-LMC Actions.docx
Focus on delivering high-quality services for your patients.
Make your standard appointment length 15 minutes.
Deliver gold-standard care to every patient.
Once you have reached 25 patient contacts per clinician in a day, use NHS 111, your local walk-in centre, or other available urgent care settings.
Stop engaging with the e-Referral Advice & Guidance Pathway.
WHAT DOES THIS MEAN?
Where advice and guidance works well for you and your patient, use this. Where it doesn’t, or there is an excessive wait over the recommended 48hr response, you do not have to use it. Instead of sending an A&G, simply send the usual referral letter to the relevant specialty.
Read the full guidance document for LMC comments and actions.
Serve notice on any voluntary services currently undertaken that plug local commissioning gaps and push back against all interface workload transfer.
WHAT DOES THIS MEAN?
This is a link to the list of services that the BMA defines as non-core – if you are delivering any of these without funding or an enhanced service contract in place, it is unfunded and voluntary.
Serve notice on any voluntary services currently undertaken which plug local commissioning gaps:
- Examples of this might be spirometry (where no enhanced service is in place); monitoring of patients with eating disorders, PSA or MGUS monitoring.
Enhanced services are also voluntary and while funded, many are not financially viable so you could serve notice on these.
- Examples of this might be Treatment Room, Phlebotomy, LARC etc...
Stop delivery of interface related workload that is transferred from other providers.
Read the full guidance document for LMC comments and actions.
Give notice on Shared Care agreements (SCAs) that impact on your ability to deliver patient care. Decline to sign any new SCAs.
WHAT DOES THIS MEAN?
Shared Care agreements are a mechanism for specialist medication to be prescribed in general practice, with support and supervision from a consultant in another provider. The funding received for this is to cover the additional workload this represents in general practice. Many shared agreements do not work well due to the monitoring burden, drug shortages or barriers liaising with specialists so give notice on those.
Read the full guidance document for LMC comments and actions.
Stop spending hours waiting on the phone when making acute referrals. Don’t risk being on hold for a long time to protect the system over the patient.
WHAT DOES THIS MEAN?
If you have a patient who requires acute admission, attempt to contact the relevant specialty/acute medical unit/admission coordinator depending on local arrangements. If they are not available within the patient’s appointment, provide an appropriate referral letter and direct the patient to A&E.
Read the full guidance document for LMC comments and actions.
Stop using referral forms. The use of referral forms and templates is not a contractual requirement.
WHAT DOES THIS MEAN?
Referral forms are largely designed for the convenience of the receiving provider and can represent a significant workload in general practice.
The BMA advises you only use these where they are of benefit to the patient and yourself. Refer your patient for specialist care when it is clinically appropriate to do so, via eRS.
We advise you to continue using urgent cancer referral forms as normal.
Read the full guidance document for LMC comments and actions.
Stop putting yourself at risk as the data controller. Withdraw permission for data sharing agreements which exclusively use data for secondary purposes i.e. not direct care.
WHAT DOES THIS MEAN?
GP partners (and any other contract holders) are the data controllers. They are personally responsible for any data sharing agreements in place.
Practices are often asked to sign numerous data sharing agreements without fully having chance to review and understand them. The liability for this does not exist for any other individual clinician in the NHS and represents an unfair risk to GP partners.
Read the full guidance document for LMC comments and actions.
Switch off Optimise RX / Medicines Optimisation Software embedded by the local ICB.
WHAT DOES THIS MEAN?
As the data controller, you are able to choose which software solutions are linked into your patient record.
Prescribe appropriately for the clinical presentation, and act in your patients’ best interests when making prescribing decisions.
Read the full guidance document for LMC comments and actions.
Do not agree yet to keep your online triage tools on throughout core practice opening hours, even when you have reached your maximum safe capacity.
WHAT DOES THIS MEAN?
“Simpler Online” Requests” - Practices who have not declared or agreed to share data as part of the “online consultation systems in general practice” publication, nor received monies, may continue to switch off their online triage tool during core hours, when they have reached their maximum capacity.