More than a quarter of appointments with general practitioners are avoidable and in many cases patients could instead be seen by a nurse prescriber, a survey of doctors has found.
An audit of more than 5,000 GP appointments in England this year found 6% could have been carried out by another professional within the practice.
In particular, a “significant proportion” of these could have been managed by a prescribing nurse, said the report, by primary care organisations NHS Alliance and Primary Care Foundation.
“The greatest opportunity to relieve pressure on GPs is by extending and making fuller use of the wider practice team”
NHS Alliance and Primary Care Foundation report
The report – called Making Time in General Practice – looked at how GPs can be freed up to carry out work only they can do.
It was commissioned NHS England in response to the escalating workload felt in general practice being driven by an “unprecedented” rise in the number of patients, increasing complexity of conditions and “growing expectations both from politicians and policy makers”.
The report, which also noted the recruitment and training crisis among both GPs and practice nurses, was produced as part of NHS England’s ambition to create a “new deal” for general practice, announced in the NHS Five Year Foward View.
“The greatest opportunity to relieve pressure on GPs is by extending and making fuller use of the wider practice team”, said this latest report.
A more diverse range of roles such as nurse practitioners, practice pharmacists and physician assistants should be considered by general practices, said the report, which called for NHS England to offer financial incentives to create more of these and other posts, such as practice nurses.
“This report documents how general practice is struggling with an increasing workload and the urgent action required to relieve this burden”
Practices should also be given more support to understand how different roles can lighten GP workload and improve care to patients, it added.
Other problems identified included poorly organised nursing care, including catheter changes, following patient discharge from hospital, and delayed discharge letters.
Rick Stern, chief executive of NHS Alliance and a director of the Primary Care Foundation, said: “This report documents how general practice is struggling with an increasing workload and the urgent action required to relieve this burden.
“We want to ensure that GPs and their colleagues in general practice are freed up to deliver the job they were trained to do and care so passionately about.”
Dr Robert Varnam, head of general practice development for NHS England, said: “General practice is the bedrock of healthcare and NHS England commissioned this report because we are determined to support GPs in reducing the pressures they face.
“The findings include helpful suggestions which should free GPs to spend more time with patients most in need and further ways to reduce the administrative burden.”
The report comes at the same time as prime minister David Cameron has announced details of a new, voluntary contract for GPs to deliver 7-day care for all patients by 2020.
The new contract will apply to federations or practices that cover populations of at least 30,000 patients. It has been designed to encourage neighbouring practices to join forces and ensure closer working with community nurses and other healthcare professionals.