Since August 2024, Humberside LMCs has seen a significant increase in the volume of interface queries they have supported practices with. Rising from an average of 35 queries per month, we are now supporting practices with around 70 queries per month. Many of the additional queries we have received relate to GP collective action. Humberside LMCs are happy to support practices with routine interface queries, as well as the rejection of inappropriate requests from other providers.
It is important to highlight that collective action is starting to produce early benefits to general practice in our region. As a result of GPs declining activity, Humberside LMCs can confirm progress in resolving some of the issues outlined below:
Midwifery requests
GPs reported that they frequently receive requests, from the midwifery team, to action the results of tests ordered by other professionals. Early on in collective action, GPs across the region rejected a large volume of these requests, over a short period of time. As a result, a working group was put together to find a solution. Whilst there is still some ongoing work to address requests in relation to diabetes during pregnancy, other prescribing requests or requests to review results, from the midwifery team, should no-longer be reaching GPs. North Bank GPs should have noticed a reduction in these requests. South Bank colleagues have not reported this as an issue but, if it is, please do notify Humberside LMCs and we would be happy to address this for you.
MAR charts
MAR charts are not contractual, and there is no requirement for GPs to complete them. A number of practices served notice on the completion of MAR charts. This includes just in case drugs. As a result, community services in Hull and the East Riding are working with GPs to rapidly implement a solution. The proposed solution is an Ardens template. If MAR charts are being requested in your area, and you would like help addressing the issue, please get in touch with Humberside LMCs and we’d be happy to address this for you.
DEXA scan requests
Practices on the South Bank reported that they were being asked to complete onerous referral forms for DEXA scans at NLAG. The questions asked were not needed to assess the clinical suitability of the referral. After declining to use a referral form, the DEXA forms were amended to include only the information needed to make the referral. We are grateful for this, and we hope that other specialities, across all providers, will consider reviewing and amending their referral forms in the same way.
Pathways
GPs have been declining to make onward referrals related to the condition or complaint the patient presented with. Having investigated many of these, it has become clear that referral pathways between providers often don’t exist. We are pleased that a number of community services are now able to refer directly to specific specialities at other providers.
Summary
Many of you are choosing to use our new workload rejection letter template. If you would like any advice or help rejecting inappropriate work, we would be happy to support you. Declining un-resourced work is a core element of the BMA’s GP collective action plan. By declining to undertake unfunded work, you are preserving ‘core’ GP services. You are also demonstrating to providers, the ICB, NHSE, and government, the significant volume of work GPs do for free and how much work is inappropriately transferred into general practice.
As a reminder, practices can find advice on these actions on our website resources section, and in the BMA ‘focus on’ document.
Collective action can be taken with ANY provider, not just acute trusts. The ICB now has systems in place to report declined activity/collective action. If you wish, you can report any instances of declined activity to primary care contracts at hnyicb-ny.primarycarecontracts@nhs.net.
If you have any questions, please don’t hesitate to get in touch with the LMC via humberside.lmcgroup@nhs.net. A reminder to please anonymise any patient identifiers to only include the NHS number. If you need to send full patient identifiers, please only do this to our GPs, Dr Zoe Norris and Dr Rolan Schreiber.
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