Overwhelmed family doctors should turn away patients once they have seen 35 in a day, GP leaders say, as anything higher is deemed ‘unsafe’.
The GPs’ union wants surgeries to be able to send patients to ‘overspill’ hubs when doctors hit that limit – similar to how hospitals can issue ‘black alerts’ to divert ambulances elsewhere when they are under extreme pressure.
The British Medical Association (BMA) has called for the patient cap to be introduced as ‘overworked and undervalued’ doctors struggle to deal with an average of 41.5 consultations a day.
It claims that 25 is the optimal level, and that anything above 35 is unsafe.
But the idea has been branded ‘dangerously crude’ by patients’ groups, which worry it will make the already scarce access to GP services even harder.
Overwhelmed family doctors should turn away patients once they have seen 35 in a day, GP leaders say, as anything higher is deemed ‘unsafe’
Patients are finding it increasingly difficult to get a routine appointment, with many already having to wait three to four weeks before they can see a doctor.
But GP surgeries are under huge strain from the rising and ageing population, with many more patients than before having treatment for complex illnesses.
They are also in the grip of a recruitment crisis, with an exodus of family doctors who are retiring or quitting without being replaced by younger trainees.
Dr Richard Vautrey, the BMA’s GP committee chairman, said that dealing with too many patients every day has become a major issue in general practice.
‘GP workloads have become increasingly unmanageable owing to the demands of more complex patient needs, widespread recruitment and retention issues, and years of underinvestment – all of which takes a toll on GPs’ physical, mental and social health,’ he said.
‘Given the clear crisis in general practice, there is an urgent need for cultural shift.
‘Having a system of overworked and undervalued GPs is unsustainable, and a change to safe working practices is vital to ensure the survival of general practice.’
According to a survey by GP magazine Pulse, doctors currently conduct an average 41.5 consultations a day.
The trade union, which represents 160,000 doctors and trainees, wants GPs to agree safe working limits which can then be enforced.
This could see surgeries in an area work together to designate one of them as an ‘overspill’ centre that would take on patients when others are overstretched.
The BMA claims that following such guidance, which it has set out in its Workload Control In General Practice report, would improve the quality of service that patients receive as well as boost the morale and wellbeing of family doctors.
The report states: ‘It will require a cultural change to remove the current noble but potentially self-destructive urge within general practice to simply work harder and longer to meet patients’ needs.’
But a spokesman for The Patients Association said: ‘Blanket decisions not to see patients above a fixed number would seem dangerously crude, and guarantees cases of people not getting treatment and care at critical times, with serious consequences for their health.
‘There should not be any move to put these arrangements in place without ensuring that there are alternative services where patients can be seen.’
Although the Government has promised to hire an extra 5,000 GPs by 2020, the most recent figures show the workforce is shrinking.
The British Medical Association (BMA) has called for the patient cap to be introduced as ‘overworked and undervalued’ doctors struggle to deal with an average of 41.5 consultations a day
An NHS report from November showed it had lost 500 GPs in 12 months, with numbers falling to 41,324.
The guidance comes as public satisfaction with GP services has dropped to an all-time low, as patients endure difficulties getting appointments and then rushed consultations.
A national survey found just 65 per cent of people were satisfied with their GP services – the lowest level in 35 years.
The Royal College of GPs said it has been advocating a warning system for some time and that a ‘black alert’ would be a lifeline to practitioners.
Its chairman, Professor Helen Stokes-Lampard, said the workload in general practice has soared by at least 16 per cent over the past seven years, which was not being matched by funding.
She added: ‘Hospitals have “black alerts” – they don’t use them when they don’t need to, they only use them when they can’t cope, to protect patient safety.
‘We don’t have an equivalent in general practice, but we need one, as it is not safe for patients to be seen by fatigued doctors and their teams.
‘A “black alert” would be a lifeline for practice teams that are overwhelmed by demand, and allow for practices to implement emergency measures to alleviate pressures.
‘It is also vital that any “black alert” system includes implementing alternative options for patients seeking emergency care.’
An NHS England spokesman said that setting a cap would not be allowed.
He added: ‘While arbitrary caps on patient appointments would breach GPs’ contracts, we understand the pressures general practice is facing.
‘Thats why the NHS is investing £2.4billion extra in GP services, growing the number of new doctors entering general practice and rolling out evening and weekend appointments to patients across England over this coming year.’