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News BMA annual representative meeting

Doctors call for cap on GP workload

BMJ 2018; 361 doi: (Published 26 June 2018) Cite this as: BMJ 2018;361:k2810
  1. Abi Rimmer
  1. The BMJ

A limit must be set on the amount of work GPs can do in a day, doctors have argued.

Delegates at the BMA annual representative meeting in Brighton on 26 June voted for the agreement of a sensible cap “on the workload of a GP which can be expected to be safely delivered in a day.”

Satish Narang, a GP who proposed the motion, said, “For the sake of quality and safety of patient care, and the sanity of GPs, we urge the BMA to take a fresh approach by defining and agreeing what is a safe workload.

“A sensible cap on the number of patients that a GP can be expected to see in a day must be introduced, taking into account that increasingly complex consultations can’t safely be managed in 10 minutes.”

In his speech to the conference ahead of the motion debate, Richard Vautrey, chair of the BMA’s general practitioners committee, said that over 90% of GPs reported considerable or high workload pressures.

“The foundation of general practice on which the NHS is built is seriously at risk of collapsing, and if the NHS wants to survive into old age we need urgent action now,” he said. “If we cherish our NHS it’s time to save general practice.”

Supporting the call for a workload cap, Sridhar Sampalli, an orthopaedic and trauma surgeon, argued that the increasing workload in general practice was harmful both to patients and doctors. “Patients are at risk of misdiagnosis,” he warned, saying that “doctors’ health can be affected.”

However, some doctors disagreed. Gary Marlowe, a Hackney based GP, said, “Capping GP appointments is the wrong answer to solving the crisis in general practice. It diverts attention from the [issue of] proper resourcing in general practice.

“There is an argument that not capping appointments will lead to unsafe care. On the contrary, I would suggest that limiting the number of appointments is in itself dangerous.”

He added, “While many of our consultations can be for relatively trivial problems, in virtually every one of my sessions there is a patient with a serious medical problem that would be impossible to identify without that consultation.

“That patient could be the first appointment of the day, or the 26th. If we choose a cap of 25 patients [a day] as has been suggested, what happens to that 26th patient?”