Please click here to report if you are being contacted with inappropriate workload letters and/or tasks. We will collate your responses and use these in our discussions with our ICBs. When completing our form, please do not include any patient identifiable information.
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.
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
The LMC has produced three template letters for practices to use when taking the decision to cease provision of non-contractual services. There are separate letters to inform the ICB, patients and hospital trust and each can be amended to suit individual practice circumstances. We hope that these suggested wordings will be of assistance.
LMC Rejected Referral Template Letter
Template Letters For Service Withdrawal
- Template Letter to the ICB for Service Withdrawal
- Template Letter to Patients for Service Withdrawal
- Template Letter to Secondary Care for Service Withdrawal
Secondary Care
- Unable to fulfil request returned to trust to action – template response letter to Secondary Care
- Patient referral rejection template
- 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
Private Work Templates
- Letter to patients requesting reports in support of disability claims
- Private GP template response
- BMA template letter response to private providers
- What happens when you are referred by your GP to see a Consultant Privately?
- DWP Appeals
Other templates & guidance you may find useful
- Inappropriate transfer of work template
- Non contractual administrative task request template
- Shared Care Protocol requests template letter
- Shared care rejection template
- Medication requests for flying
- Fit to fly during pregnancy – advice and template letter
- Inappropriate prescribing requests template response letter
- GP Workload: Core and 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
With thanks to Lancashire and Cumbria LMCs for sharing above template letters.
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.