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New Tools to Support General Practice Move Work Back to Hospitals

From 1st April 2017, the 2017/18 NHS standard contracts for secondary care trusts have came into force. The new contract has placed new requirements on hospitals to lessen inappropriate bureaucratic workload shift onto GP practices.

Now, GPs in England are given support to make sure that unsuitable workload from secondary care is returned to hospitals and treatment for patients becomes quicker.

The new guidance published by the British Medical Council (BMA) contains information, checklists and letter templates to help general practices manage inappropriate workload.

Dr Chaand Nagpaul, the chair of General Practitioners Committee (GPC) sent a letter to GPs saying that he is very pleased to announce that they have as a result secured important changes to the hospital contract in England for 2017-18. These build on last year’s 2016-17 hospital contract changes following GPC pressure which include

  • Hospitals should directly communicate with patients should they miss an outpatient appointment rather than ask GPs to re-refer.
  • The results of enquiries requested by hospital clinicians should be communicated by the hospital directly to patients
  • Hospitals should make direct internal referrals to another department or clinician for a correlated medical problem rather than send the patient back to the GP for a new referral.

According to the BMA, the new changes on the 2017-18 hospital contract would also decrease inappropriate workload on GP practices and advance patient care across the primary/secondary care interface in different ways. These includes:

  • Hospitals must not transfer management under shared care without prior contract with the GP
  • Hospitals issuing fit notes after a patient has had a hospital procedure
  • Hospital clinic letters to be received by the GP within ten days and within seven days from 1 April of next year.
  • Hospital trusts responding to patient queries for matters relating to their care such as hospital test results, treatment and investigations.

Dr Chaand said that the government has listened to the BMA’s requests in Urgent Prescription for General Practice campaign and agreed to a series of hospital contract changes intended at holding NHS managers to account.

He further added that the new requirements aim to reverse a culture spanning decades of secondary care passing on inappropriate workload and bureaucratic demands on GP practices.

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