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 scheme click here. 

The BMA has proposed a workload control strategy to address the factors involved.

Please also see previous BMA documents on Safe Working in General Practice 2016 and Saving General Practice Report 2017.

Fit Notes

For fit note guidance for GPs you can see the Department for Work and pensions guide which covers Information for GPs about on how to complete each section of the fit note, with case studies to show different situations. 

Some key points:

  • Doctors are required to issue fit notes free or charge
  • You do not need to issue a fit note for the first 7 days of a patient’s sickness absence. Patients can self-certify for this period

For further guidance please see the BMA website.

For guidance on who can certify fit notes for healthcare professionals and their employers please see the gov website here.

LMC Templates & Policies for managing inappropriate workload

Letters to schools

Requirement for medical evidence to support authorised absence due to illness 

Over the Counter (OTC) Medicines for Children - Blackpool Council and LMC joint letter 

LMC statement - Letter to patients requesting reports in Support of Disability Claims

Secondary Care:

Work transfer - template response letter to Secondary care (with thanks to Cambs LMC)

Patient referral rejection template (with thanks to Cambs LMC)

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.