In response to GPs, practice team members and patients facing increasing occurrences of unsafe situations in general practice we have launched new resources to support practising safely, including bringing patients onboard with the necessity of this approach.
Dr Lisa Harrod-Rothwell, Deputy CEO, Londonwide LMCs and lead on safe working, said:
“Safety in general practice is a growing concern for GPs and those they care for. And it is distressing that in 2024 most practices in London feel unable to deliver care that is either safe for patients or staff. That is why we have developed and launched our new safety resource pack, supporting London’s general practice teams who are currently dealing with unsafe workloads across the Capital.
“Whether due to the demand: capacity/ capability mismatch, system operational failings, or pressure to operate beyond the limits of their expertise, we are responding to staff concerns about safe practice and threats to safe patient care driving stress and worsening mental health. If we don’t find a way to address this soon retention will continue to be an issue and GPs will continue to leave. If workforce numbers keep dropping the safety and quality of the service we offer to our patients will decline even faster.
“With resources to manage workload, our new guide on dealing with abusive and violent patients, guidance on managing access, a patient participation pack, template letters and responses, posters, and guidance on reporting operational pressures, these dedicated resources will help practices manage the growing demands they face.
“We have also developed guides and tools on working in partnership with patients: the time has come for those working in general practice to join with their patients. No patient wants to arrive in the consulting room to find an emotionally and intellectually exhausted GP, who lacks the time to hear their concerns, who is distracted by multiple competing demands and who no longer can ensure patients’ access to wider NHS services they need. No GP wants this either.
“Whilst general practice recognises the immense unprecedented pressures facing the NHS and politicians to achieve financial balance despite immense resource and NHS workforce constraints, increasing patient and population need and increasing expectation, rationing that has reduced patients’ access to specialist services. We need political leaders to be honest about what they can expect from general practice and take accountability for their prioritisation, policies and decisions that have resulted in most GPs in London now feeling that there are unable to deliver safe care.”
Dr Elliott Singer, Medical Director, Londonwide LMCs and lead author for the Abuse and violent patient guide said:
“The rising abuse and violence faced by practices is deeply concerning and while we believe this new guidance will help with keeping practice team members and patients safe, it is regrettable that it is required at all. The document covers steps practices can take to reduce the chances of patient behaviour escalating into abuse or violence. It also details how to plan for scenarios where this unfortunately cannot be avoided.
“We hope this guidance is useful, but there is only so much practices can do themselves. They need the support of commissioners in removing aggressive patients to properly resourced special allocation schemes and a timely response from local police at the point staff or patients feel threatened. They also need political leaders to be clear with patients about what they can expect from general practice with the resources it has available.”
- Note: the guide includes contributions kindly shared with us by MDDUS.
Background
Safety resources
- Safe working pack – a new collection of resources designed for GPs to have open during consultations, gathering together new, updated and existing materials.
- Abuse and violent patient guide – a new document providing extensive advice and tools for practices to help manage and mitigate the unfortunate rise in patient abuse.
- Patient participation support pack – these new materials help practices to build support and understanding of how they are prioritising work to safely meet patient needs, while under unprecedented pressures.
- Template letters – these updated letters can be used to push back on un-resourced work, so GPs can focus on essential activity that keeps their patients safe.
- Posters – used alongside the template letters, these refreshed posters can help to build patient understanding of what they can expect from their GP.
- Guidance documents – covering a wide range of topics, our guidance helps GPs and practice teams to navigate what activity they are responsible for and stay safely on the right side of regulations and requirements.
Statistics
Londonwide LMCs December 2023 workforce survey found that of the practices who responded:
- Less than a quarter of practices feel optimistic about their ability to deliver safe patient care over the coming months.
- Over three quarters of practices, an increase of 5% on the previous wave, say their ability to deliver safe patient care is being impacted by workload shift from other providers. Of these practices:
- 90% cite inability to absorb additional workload.
- 51% cite operating outside the boundaries of their clinical expertise.
- Two thirds of practices say that workloads are negatively impacting on the health of their staff.
Workforce, patient and practice data – ten year picture
Using information from NHS Digital and other official sources, this resource, created by colleagues in Bedfordshire & Hertfordshire LMCs we can see the London region has experienced these changes between 2014-2024.
- 21.0% population increase
- 14.8% fewer FTE GPs
- 41.2& more patients per each FTE GP
- 28.7% reduction in GP partners, who run GP practices and without whom a local surgery has to close