Hospitals Ignoring Contract Changes and Dumping Work on GPs Evidence Shows

A poll of doctors suggests that hospitals in the NHS are failing to pay heed to changes in standard contracts intended to prevent work being unreasonably dumped on GPs.

NHS England had published guidance to accompany the 2016/17 standard contract that was intended to ease the workload of doctors working within the NHS system.

Under the guidance, hospitals should refrain from enforcing surgeries to re-refer patients unnecessarily, or to prescribe medication on behalf of hospital doctors.

The changes to policy were aimed at ensuring hospitals issued discharge letters more promptly, and also in a convenient electronic form.

Yet the poll conducted by GPOnline suggests that this guidance is being largely ignored, with 72% of respondents indicating that hospitals continue to operate blanket policies discharging those who miss hospital appointments back into the GP system.

This has been specifically referenced to as poor conduct by NHS England, with guidance from the organisation tbeing that “hospitals will not be able to adopt blanket policies under which all patients who do not attend clinic are automatically discharged back to their GP”.

And only 2% of GPs responding to the poll indicated that trusts deal directly with discharge summaries within 24 hours, while 15% stated that hospitals do not send discharge summaries electronically.

A letter distributed by NHS England to CCGs and NHS trusts on 28th July already indicated that the organisation was well aware that guidance was effectively being ignored.

The letter highlights six new requirements for hospitals “introduced in the 2016/17 NHS standard contract to clarify the expectations across the hospital and general practice interface and reduce avoidable extra workload for GPs and help release time. It is important that they are fully implemented in a robust and timely way and we urge you to do this”.

GPC chairman Dr Chaand Nagpaul had spoken on the issue at the BMA annual representative meeting earlier this year, commenting that GPs were being treated unfairly by existing procedures in the NHS, and that this is leading to needless workload for already burdened professionals.

“The explicit wholesale transfer of care out of hospital continues unabated. GPs are absorbing this burgeoning workload, with 70m more patients seeing us annually compared to seven years ago and with fewer GPs per head, which is drowning our capacity to cope”.

An NHS England spokesman commented that regional healthcare organisations must enforce contractual provisions.

“Recent changes in the NHS standard contract set out clear legal requirements aimed at cutting the burden of bureaucracy on GPs, which is not good for local health services or patients. These changes must be driven at a local level by CCGs, working with their hospital colleagues. NHS England, together with NHS Improvement, has written to all NHS trusts, foundation trusts and CCGs to emphasise these requirements as we implement the support measures set out in the GP Forward View.”

 

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