GP clinical administrative workload has been rocketing compared with the same time in 2019 despite the increasing availability of digital solutions.
According to data gathered by the Royal College of GPs, doctors themselves have also seen an increase in consultations – 8.4% higher than during the same weeks before the pandemic. This is a very different picture to the one being painted by the media and shows the huge effort being put in by everyone working in primary care.
But the increase measured is even higher than the data suggests since it does not include the work primary care clinicians and staff have been doing on the Covid-19 vaccine programme. It may also underestimate the phone consultations being carried out by GPs.
The admin tasks, including prescriptions, referral letters, messages to patients and calls, were 34% higher than the same five week period where the use of digital methods were not so commonplace or readily available.
There is a crisis in primary care, created by a combination of ever increasing patient numbers and a decline in the number of GPs per patient over the last five years.
Smarter ways of working are needed to ensure there is not an overload in the health service’s front door and many of those can be achieved by using digital methods to streamline admin processes and apply machine learning to patient triage.
Over the entire first 20 weeks of 2021, the clinical administrative workload for GPs has been 20% higher than in the same period in 2019 – and 58% above the level seen in the first 20 weeks of 2020 when working practices dramatically shifted because of the pandemic. The whole NHS had to deal with a rapid change to new working methods but nowhere was this seen more than in GP practices. As other areas of the NHS stopped certain services or discharged patients to deal with an expected influx of covid-19 patients, primary care kept its doors open.
And even with the shift to telephone and video consultations, NHS England’s findings show that more than half of GP consultations have been carried out face to face.
The RCGP’s chair commented on the findings saying that the teams were “working flat out”. But with a considerable backlog to deal with, plus patients coming forward with health concerns they may have not wanted to bother GPs with during the pandemic, there will be no down time for anyone working in healthcare come the much anticipated ‘freedom day’.
‘GPs and their teams have been working under unsustainable pressures for many years now and we need to make the job of a GP manageable and fulfilling again so that we keep hardworking and dedicated GPs where they want to be – caring for patients.
‘This is why we need to see urgent action to address the workload and workforce pressures facing general practice. This includes initiatives in place to retain experienced GPs in the workforce, and prevent them from burning out, and leaving the profession altogether.’
RCGP chair Professor Martin Marshall
But the answer isn’t to just digitalise legacy methods. It’s to evolutionise working practises so they suit the needs of clinicians and patients.
The Covid vaccination programme showed the success of moving to new ways to contact patients and patients were extremely receptive to it.
But the support for one form of digital contact has not been seen in other areas, such as video consultations or online triage. Indeed, patients feel ‘fobbed off’ if they get offered anything other than a face to face appointment with their GP – even if clinically it is not necessary.
With Primary Care Networks bringing to life the possibilities of sharing resources across practices, allowing patients to be contacted when it is convenient for them without having to take time off work and clinicians themselves being able to work from one single location and review patients from a list of tens of thousands, the work load for clinicians should be decreasing – or at least stabilising. Instead what we are seeing are constantly congested telephone lines and the worrying trend of a return to admin tasks which can be done online.
The technology that powers so much of the world today can help primary care face the challenges of tomorrow.
But the methods we use in our day to day lives for shopping or even booking a holiday we reject when it comes to accessing healthcare. Why?
Whatever the reason, these reported trends have the opportunity to be reversed by both professionals and patients adopting digital methods of working and accessing care.
And unless they do, the sort of world beating results which saw the UK deliver the Covid vaccination programme will be a massive opportunity lost.