#GPFUQ 70 Why must GPs reduce the burden of paperwork? It increases the barriers to good care.
The paperwork in paperless offices is worse than ever. The burden of administrative tasks keeps increasing. This can make life harder for patients by erecting barriers to protect GPs from this increasing administration work. If GPs don’t do the work – will patients have to work harder or make more or different appointments with many different staff for different services? It won’t be a good service for patients (or a good marketing strategy for GPs) if a GP who has traditionally provided an accessible ‘one stop shop’, increases the barriers to care, reduces accessibility to or reduces range of services on offer for patient.
The paperwork in paperless offices is worse than ever. The burden of administrative tasks keeps increasing. This can make life harder for patients by erecting barriers to protect GPs from this increasing administration work. If GPs don’t do the work – will patients have to work harder or make more or different appointments with many different staff for different services? It won’t be a good service for patients (or a good marketing strategy for GPs) if a GP who has traditionally provided an accessible ‘one stop shop’, increases the barriers to care, reduces accessibility to or reduces range of services on offer for patient.
Some suggestions for action
- Keep a clean
/ clear desk policy. If you can’t do this then get advise on what you have
to do to achieve this.
- Reduce the
time spent on practice management as much as possible - recruit a
well-qualified manager as employee or business partner to manage the
partnership and practice business
- Don’t write a
letter to a patient if a phone call or text would be quicker
- Delegate all
administration (see FUQ 60-62) to your staff
- Appoint a
clerk to run processes like the Choose and book appointment system
- Use wholly
computerised records – don’t run duplicate systems on paper and computer
- Use forms in ‘Word’ and present in a
way that allows merging with GP clinical systems
- Reduce your
paid and unpaid subscriptions to societies, magazines and mailings to a
minimum
- Throw away
most journals, unfocussed reading, etc
- Unsubscribe
from unwanted / less important e-mail systems
- Don’t respond
to unsolicited questionnaires
- Use READ
codes more to record clinical information
- Pick the
important information and actions required from incoming letters, and
routine investigations results to alert you if need to do something
- Don’t attend
administrative or representative meetings unless your presence will
directly contribute to the outcome of the meeting.
- Don’t attend
unnecessary training e.g. how to give a flu vaccine when you are giving
injections all the time
- Don’t do any
low-end clinical work (vaccinations etc.) that could be transferred to
other staff.
- Ensure office
staff have month by month tickler files that remind them to routinely
repeat searches, e.g. patients on warfarin without an INR for 3 months
- Designate a
Duty administrator i.e. someone each half day that can do all those jobs
like... chasing appointments, finding consultants secretaries, relaying
messages etc
- Use the administrative
team to prepare medical certificates, insurance reports etc
- Use the
administrative team to contact patients (a medical assistant can do this)
- Use the
administrative team to chase hospital system
- Use the
administrative team to chase social care support (social services and
community matron can lead this)
- Use the
administrative team to monitor chronic disease and make adjustments to
standard drug regimes
- Don’t
participate in any process work and planning meetings without specific
goals
- Don’t
participate in any audits for their own sake, only those to improve
patient care
- Use annual or
birthday based medical reviews of all chronic diseases at one visit per
year
- Have Practice
protocols for consistency of approach - e.g. patients arriving late,
dealing with housing letter requests, etc
- Use internal
electronic messaging or have a paper system on trolley outside consulting
room (in a practice where patients are waiting away from this corridor). Sort
into different shelves - routine hospital letters/ probable junk and
magazines/ urgent requests inc urgent prescriptions and messages from
consultants, etc. This can be helpful for reception team who would know that the urgent basket
would be looked at as morning went on and didn't therefore disturb the
doctor,
- Use the
administrative team to provide up to date database of contact telephone
numbers, service provisions et- kept up to date and accessible to locums
as well as regular doctors.
- Use the
administrative team to provide up to date standard locum packs such as
that provided by National Association of sessional GPs (NASGPs)
- Use the
administrative team to facilitate Patient Participation Groups
- Use the
administrative team to facilitate Patient Therapy Groups
- Have
excellent full team away days. There should be funding and support for one
every year.
- Lobby RCGP and GPC to help end unnecessary
structures and processes in general practice faster – there is a legacy of
unnecessary chores that GPs do that we need to collaborate about to change
e.g. many sick notes for patients add nothing to the care or management of
the patient. RCGP or similar needs to take a lead in ‘best practice’.
- Maintain up to date disease registers in the practice
- Share work with
multidisciplinary teams when appropriate
- Concentrate on the complex medical decision-making that is often done
face to face.
- Don’t collude
by allowing reception staff to triage patients, due to a lack of clinical
staff time.
- Have
ring-fenced time for vital non-consultation tasks.
- Protect
learning time for leaders in practice
Please send me your suggestions to add to this list
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