Intended for healthcare professionals


GPs call for cut in red tape to manage aftermath of covid-19

BMJ 2020; 370 doi: (Published 07 July 2020) Cite this as: BMJ 2020;370:m2729

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  1. Jacqui Wise
  1. London

The Royal College of General Practitioners has called for a permanent reduction in “box ticking exercises” to give GPs more time to focus on delivering patient care in the aftermath of covid-19.

The college’s report, General Practice in the Post Covid World, says that the pandemic has brought a welcome relaxation of the bureaucratic and administrative burdens usually imposed on general practice.1 This includes the temporary suspension of practice inspections, of the Quality and Outcomes Framework(QOF) in Northern Ireland and England, and of the Quality Assurance and Improvement Framework (QAIF) in Wales, as well as the relaxation of appraisal and revalidation requirements.

The report says that, despite a need for regulation to ensure patient safety and quality of care, a shift to a “higher trust” model is necessary to give GPs more time to deliver clinical care for patients. The college has called for “intelligence led monitoring” on the quality and safety of care so that inspections by the Care Quality Commission are carried out only where there are indications that a practice may not be performing adequately or where significant concerns have been raised.

It calls for the QOF and QAIF to focus on high trust approaches to assuring or improving quality, with low administrative requirements. The report recommends a new yearly appraisal system throughout the UK that minimises pre-appraisal documentation and the administrative burden on GPs and focuses on wellbeing, reflective practice, and development.

Longer term effects

During the covid-19 crisis a streamlined approach has allowed doctors to return to the workforce more easily. The Royal College of General Practitioners advises a rapid review of the requirements for returning GPs, to evaluate which elements of this could be maintained and built on.

The college says that general practice is preparing for an influx of patients with “long covid”—those who have recovered from the virus but continue to have symptoms such as respiratory difficulties, cognitive impairment, and chronic fatigue. It called on the four governments of the UK to produce a plan to support GPs in managing the longer term effects of covid in the community.

Martin Marshall, chair of the college, said, “While we recognise that regulation has a place in general practice, the fact is that 95% of GP practices are rated good or outstanding. Making GPs and our teams go through box ticking exercises has little patient benefit and isn’t the best use of our time, especially as we deal with the expected surge in clinical workload in the aftermath of covid-19.”