Safe Working Limits

The BMA has recently issued the following statement to practices.


General practice continues to face overwhelming pressures, with unmanageable workloads, coupled with a rapidly shrinking and exhausted workforce. The COVID-19 pandemic has generated a vast backlog of care, which is so far largely unmeasured and unrecognised in general practice, exerting greater pressure on a system already at breaking point.


The pressures practices are under are evident from the most recent GP appointment data which shows that in August, practices in England delivered a staggering 3 million more appointments than in the same month in 2019, meaning we are now managing the levels of demand used to see in a pre-pandemic winter in the middle of summer, fighting an uphill battle to meet patients’ needs, with fewer GPs.


It is therefore disappointing to see the announcement by the shadow health secretary last week demanding that GPs provide face-to-face appointments for every patient who wants them, making divisive headline-grabbing promises that are not grounded in reality suggesting the existing workforce are somehow not trying hard enough.


The present crisis is so acute that we now recommend practices take urgent action to preserve patient care and their own wellbeing, and have updated our guidance on Safe working in general practice, which is designed to enable practices to make decisions as to how to prioritise care, and deprioritise certain aspects of their day to day activity, within the confines of the GMS contract. As part of this guidance, we strongly recommend practices take immediate measures to move to 15 minute appointments, move towards capping consultation numbers to a safe number per day – safe for clinicians and safe for patients. Excess demand beyond these levels should be directed to NHS 111, extended access hubs, or other providers.


Changing the way we work would allow practices to devote their resources to those patients and problems that general practice is uniquely positioned to help, and those with the greatest need, and not simply as a provider of last resort for other parts of the NHS and social care. Practice might also want to read our guidance on How to improve the safety of your service and wellbeing of your workforce, setting out safe limits of the numbers of patient contacts per day, and what is considered ‘essential services’ under the GMS contract.

First Published
7 October 2022
Updated On
1 October 2023
Due to be Reviewed
1 October 2025
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