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Length of GP appraisals could be cut to 30 minutes under government plans


By Rachel Carter
24 November 2020

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The length of GP appraisals could be cut to just 30 minutes as part of the Government’s drive to reduce bureaucracy for health professionals, the Department of Health and Social Care (DHSC) has announced.

The new appraisal process, which is ‘currently being evaluated’, would also see a significant reduction in the supporting evidence GPs are expected to provide, DHSC said.

Streamlining medical appraisals is one of eight priority areas set out in the Government’s response to its recent consultation on reducing bureaucracy in the health and social care system.

The report, published today (24 November), said the new appraisals were introduced in October by NHS England, the GMC, BMA and the Academy of Royal Medical Colleges, and will be evaluated over the next 12 months.

The process includes a new format that takes about 30 minutes to prepare – compared to three to five hours previously – and an emphasis on health and wellbeing questions in the appraisal discussion.

Under the new model, doctors are also expected to update their scope of work, review previous personal development plans, and reference details of significant events or complaints in which they were named – but no further additional supporting information will be required.

‘If the evaluation concludes that more supporting information is required for revalidation purposes, serious consideration must be given to whether organisations take on more of that burden than previously, rather than simply to pass it back to the doctor,’ DHSC added.

Patient record management

According to DHSC, the consultation received responses from 600 health professionals, who identified 1,000 examples of excess bureaucracy they face in their day-to-day job.

It found patient record management was the area where frontline staff experience the greatest bureaucratic burden, with nurses and midwives reporting this ‘particularly frequently’.

‘Having to navigate multiple systems that often do not effectively interact with each other to enter and retrieve information was cited as a common source of stress,’ the report added.

Other top areas of frustration for professionals were ‘data requests from other organisations or central government’ and ‘performance assessment or management of clinical staff’.

The report also identified several key changes that have happened during the Covid-19 pandemic, which DHSC said could be used to learn lessons from going forward. This included changes to the hospital discharge model, the suspension of routine CQC inspections, providing support using digital tools, and streamlining recruitment processes.

One consultation respondent said: ‘Over the past five months bureaucracy went out of the window. Covid in some way caused terrible things but it was also a disruptor and it gave us a once in a lifetime chance to think about what we’re doing and how we make a difference.’

Regulation reforms

Reforms to professional regulation were also identified as another priority area by the DHSC, after the consultation highlighted concerns that current legislation is overly prescriptive.

This would include reforming the legislation that currently sees overseas doctors who want to work in the NHS submitting up to 1,000 pages of evidence to support an application, DHSC said.

The Government will also look at making improvements to the fitness to practice and complaints process, and adding physician and anaesthesia associates to the list of regulated professions, the report added.

The DHSC will launch a consultation on its proposals for regulation reforms in early 2021.

Charlie Massey, chief executive of the GMC, said: ‘We must do all we can to support highly-skilled doctors from overseas who can and want to fill in-demand roles as GPs and consultants. Legislative change will free us to cut burdensome red tape while ensuring high standards are maintained for patients in the UK.

‘We welcome the Government’s continued commitment to these important reforms and hope they can be enacted quickly, to benefit our workforce and patients as soon as possible.’

‘Seize the moment’

Speaking at the NHS Confederation’s NHS Reset Conference today (24 November), health secretary Matt Hancock, said: ‘Of course, rules and regulations have their place. They can be the cornerstone of high-quality care. But when left unchecked, rules and regulations can outgrow their original purpose – and they can stifle innovation and damage morale.’

He added: ‘I’m determined that we seize this moment and build on the very best of what we have seen over these past nine months.’

Lou Patten, chief executive of NHS Clinical Commissioners, said the pandemic had demonstrated that ‘streamlining bureaucratic processes’ frees up for time and resource for clinical and managerial staff.

She added: ‘What we have heard from our clinical commissioner members, and has been acknowledged today by the Secretary of State for Health and Social Care, is that the NHS cannot return to its old ways of overly burdensome reporting and paperwork.

‘These new ways of working must now be embedded both in the culture of the NHS and in any forthcoming legislation, so that our health and care leaders and clinicians can get on with delivering the best care possible for the patients and populations they serve.’

The Government’s eight priority areas for reducing bureaucracy

  1. Data and information will be shared, asked for and used intelligently
  2. System and professional regulation will be proportionate and intelligent
  3. Day-to-day staff processes will be simple, helpful and effective
  4. The Government will legislate to make procurement rules more flexible
  5. GPs will have more time to focus on clinical work and improving patient care
  6. Medical appraisals will be streamlined and their impact increased
  7. There will be greater digitisation of services
  8. A supportive culture is needed at a national and local level. 

 

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