Most of us, at some time would have received an email from the ICB or formerly the CCG notifying us that the trust, ambulance service etc was OPEL 4 and could we please stop using them. Regardless of your thoughts on the use of this and what we can change, one of my biggest issues is that so are we, but no-one seems to care that at times, general practice is also not able to cope with the workload.
There are many reasons behind this including the available workforce, patient demand and the pressures put upon us from the rest of the system. Since 2020 Devon LMC has been utilising their GP alert system (GPAS) to enable practices to report in an equivalent way to OPEL on the pressures they are experiencing. They have agreed a pilot system to assess how the ICS responds when practices are under severe, extreme or intolerable pressure. Over the past year Londonwide LMCs has been rolling this system out on behalf of London general practice.
In July 2023, NHS England announced that there needs to be an OPEL equivalent system for all practices, and they wanted this in place in the next year. Practices now have a choice, do they report their service pressures directly to the ICB or to use GPAS and report these pressures through the LMC?
As the Londonwide LMCs medical director overseeing the rollout of GPAS, I would of course tell you to use GPAS, but why? Sadly, I have far too often seen data used for judgement about a practice performance. There is a risk that if the ICB directly holds your data, this could be used as part of the assessment of the practice both by the primary care commissioning teams and CQC.
GPAS is different, individual practices cannot be identified from the information and it is reported at a borough level. This helps change the narrative from it being a problem with ‘a poorly performing practice’ to one that recognises it is a systemwide problem and not an individual practice issue and as such needs a systemwide response to resolve not pressure put on a practice that is already under increasing stress.
We do need to demonstrate to the rest of the NHS system the pressures that general practice is under. If we don’t do this ourselves, the ICBs as instructed by NHS England, will implement their own data gathering process. We have a window of opportunity to implement a system for ourselves, led by the LMC, which won’t put individual practices at risk for honestly reporting their status. Sign up now via our GPAS sign-up form before it is too late, and you lose this choice.
Dr Elliott Singer is Londonwide LMCs’ Medical Director lead for GPAS and a GP in North East London.