GPs and practices are under exceptional pressure. GPs are being overwhelmed by rising workload, particularly from a growing patient need. At the same time there is an emerging workforce crisis with shortages of GPs leaving many practices unable to recruit doctors and evidence that some experienced GPs are considering leaving general practice altogether.
It is unsustainable, unsafe and unfair for GPs to be working excessive hours at the expense of their own health. Given the changes to workforce may take years to be realised, workload must be addressed urgently. General Practice is stressful and at times we may all need support and help. The LMC are working alongside the NHS Practitioner Health service that has trained mentors who provide confidential support for local GPs. For more information on the GP support & development service click here.
Please see the BMA - Safe working in general practice where they have generated a guide to enable practices to prioritise safe patient care, within the present bounds of the GMS contract.
The BMA has also proposed a workload control strategy to address the factors involved.
LMC Templates for managing inappropriate workload
Advice for Schools
Requests for medical evidence to support pupil's authorised absence due to illness:
- Lancashire County Council and LMC joint letter
- Blackburn with Darwen Borough Council and LMC joint letter
- Blackpool Council and LMC joint letter
Requests for letters to support special consideration for examinations:
Over the Counter (OTC) Medicines for Children:
Toilet pass letter
Secondary Care
- Unable to fulfil request - returned to trust to action- template response letter to Secondary care - Lancs & SC (with thanks to Cambs LMC)
- Unable to fulfil request - returned to trust to action- template response letter to Secondary care - Cumbria
- Patient referral rejection template (with thanks to Cambs LMC)
- Post operative checks requests template letter to Secondary Care
- Work transfer - template response letter to Secondary Care
- Letter template for rejecting sedative requests for patients (Fylde Coast)
- Expedite Letter Requests - template
- Monitoring of Monoclonal Gammopathy of Undetermined Significance (MGUS) - Practice Patient Letter
- Monitoring of Monoclonal Gammopathy of Undetermined Significance (MGUS) - Hospital Letter
- Monitoring of Monoclonal Gammopathy of Undetermined Significance (MGUS) - Patient Letter
- Monitoring of Chronic Lymphocytic Leukaemia - Practice Patient Letter
- Responsibility for Chronic Lymphocytic Leukaemia (CLL) Monitoring
- Disclaimer Template for not using Standard Referral Letter
Private Work Templates
- Letter to patients requesting reports in Support of Disability Claims
- Private GP template response
- BMA template letter response to private providers
- Private GP poster
- What happens when you are referred by your GP to see a Consultant Privately?
- DWP Appeals
- ADHD Patient Rejection Letter - (Private Provider)
- ADHD Rejection Letter to Private Provider
Other templates & guidance you may find useful
- Inappropriate transfer of work template
- Non contractual administrative task request template
- Shared Care Protocol requests template letter (with thanks to Cambs LMC)
- Shared Care rejection template
- Medication requests for flying (With thanks to Cambs LMC)
- Fit to fly during pregnancy - advice and template letter
- Inappropriate prescribing requests template response letter
- GP Workload: Core & non- core work
- Bariatric Surgery Aftercare- inappropriate requests of primary care
- Request for aftercare following treatment abroad
- Template letter for declining monitoring and prescribing - gender dysphoria
- Request for Inclisiran administration - rejection template
- Response to Requests for GPs to Review Patient Records Prior to Private Providers Prescribing Wegovy or Mounjaro
BMA templates for pushing back on inappropriate workload
The BMA have created letter templates to help practices push back on inappropriate workload from ICBs, prescribers, hospitals and your area team. The letter templates include:
- Secondary care work transfer
- Inappropriate prescribing requests
- Requests to follow up investigations performed in other settings
- Requests for post-operative checks
- Letter to hospital provider regarding discharge of patients after missed appointment
- Letter to local ICB regarding discharge of patients after missed appointment
- Letter to IBC regarding inappropriate workload transfer
- Letter for request to complete non-contractual administrative task
- Requests for work absence sick notes for less than seven days
- Letter to area team regarding delay to information request or payment
- Letter to hospital provider regarding follow up of diagnostic test results following a patient's discharge from hospital
- Letter to ICB in response to requests to follow up investigations performed in other settings.
Vaccination and Immunisations
Please see the BMA website for guidance on the national arrangements for providing vaccines and immunisations. You will also find GP contract related changes to vaccinations and immunisation programmes, changes to existing vaccination programmes and continuing vaccination programmes. You may also find the following link on travel vaccinations useful.