Cut red tape for GPs, urges report

BMJ 1995; 311 doi: (Published 12 August 1995) Cite this as: BMJ 1995;311:408

Sixty five recommendations to reduce the bureaucratic burden on Britain's general practitioners have been made in a government report that claims that “fifteen million forms a year could be torn up” if they are implemented.

The recommendations are based on the findings of an “efficiency scrutiny” set up by the government as part of a drive to reduce unnecessary paperwork in general practice, schools, and the criminal justice system.

Top of the list for rationalisation is the way in which general practitioners are paid. Currently the fees and allowance structure has 22 components.

These range from capitation fees, which account for about half of a general practitioner's income, to small item of service fees for vaccination, contraception, and other services, for which the completion and processing of the forms are disproportionate to the amount of money involved.

The solution, the report proposes, is for the NHS Executive to scrap the current forms and replace them with fewer, better designed forms covering patient registration, maternity services, and services to non-registered patients. A multipurpose and multipatient booklet would replace the separate item of service claim forms.

The report also focuses on exploiting the potential of computers in general practice. It says that the national NHS information technology strategy “is not widely understood and owned by primary care staff” and that “national projects have not been pursued with sufficient vigour.” The “GP links” programme, in which general practitioners' computers are linked with those of their family health services authority (FHSA) and paper communication is replaced by electronic data exchange, has been slow to get off the ground. The report says that the NHS Executive should ensure that all FHSAs appoint a senior manager to implement the project locally and “use their discretion to provide 100% reimbursement” for the costs of equipment and human resources.

Dr Judy Gilley of the General Medical Services Committee said, “Any initiative that it is going to cut down the amount of bureaucracy in general practice is welcome. It is also high time that GP computer strategies were looked at rationally. Development has been very haphazard, with individual FHSAs doing their own thing. The key issue, however, is how and whether the recommendations are implemented. FHSAs have only limited resources, and these recommendations are going to entail a lot of detailed work and financial investment to take them beyond the pilot projects to the stated goal of the majority of the report being implemented within 18 months. The way the report is implemented is also crucial. Changes should be introduced only with the full understanding and cooperation of the medical profession. Doctors don't want yet another set of diktats imposed on them.”--TESSA RICHARDS, BMJ


Computers could be exploited more in general practice

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