Scenarios for safe working in general practice

Scenario 1: Full capacity

Q: What do we do when we are fully booked? Where do we send patients? Will we be in trouble with the ICB if we tell patients we are full?

A: When your practice reaches full capacity, it is crucial to prioritise patient safety and well-being.

The BMA guidance recommends:

Triage and Signposting: Implement a robust triage system to assess the urgency of each case. Non-urgent cases can be redirected to other services such as community pharmacies, NHS 111, or walk-in centres.
Collaboration with Other Practices: Coordinate with neighbouring practices within your Primary Care Network (PCN) to share the workload and ensure patients receive timely care.
Communication with ICB: Inform your Integrated Care Board (ICB) about your capacity issues and the steps you are taking to manage patient care. Transparency and proactive communication can help avoid any potential issues with compliance.

Q: How do we manage patient expectations when implementing safe working practices?

A: Effective communication is key to managing patient expectations:

Clear Information: Provide clear information about appointment availability and the rationale behind setting safe limits. Use posters, websites, and patient leaflets to explain the measures being taken to ensure safe and high-quality care.
Alternative Options: Offer patients alternative options for non-urgent care, such as telephone consultations, online consultations, or advice from pharmacists.
Empathy and Understanding: Train staff to communicate empathetically with patients, acknowledging their concerns while explaining the importance of these measures for their safety and the well-being of the healthcare team.

Q: What should we do during high demand periods, such as flu season or public health emergencies?

A: During periods of high demand, the following strategies can help manage the increased workload:

Flexible Staffing: Increase staff availability through locum GPs or extended hours, if feasible. Consider employing additional administrative staff to handle the influx of calls and appointments.
Prioritise Care: Use triage to prioritise patients with urgent needs and chronic conditions that require timely intervention.
Utilise Technology: Encourage the use of online consultations and telemedicine to reduce the pressure on in-person appointments.

Q: How can we support staff well-being and prevent burnout in our practice?

A: Supporting staff well-being is essential for maintaining a high standard of care:

Regular Breaks: Ensure that all staff members take regular breaks and have access to a quiet space to rest and recharge.
Support Services: Provide access to mental health and well-being support services, such as counselling or employee assistance programs.
Team-Based Approach: Foster a supportive team environment where staff feel comfortable discussing workload issues and seeking help when needed.

Q: How do we implement safe limits on patient contacts without compromising patient care?

A: To implement safe limits effectively:

Set Clear Policies: Develop and communicate clear policies on the maximum number of patient contacts per day. Ensure all staff understand and adhere to these limits.
Monitor and Adjust: Regularly review and adjust the limits based on feedback from staff and patients, and the specific needs of your practice.
Patient Education: Educate patients about the importance of safe working practices for ensuring high-quality care and preventing burnout among healthcare providers.

Q: How can we ensure compliance with the BMA's Safe Working guidelines?

A: Ensuring compliance involves several steps:

Regular Audits: Conduct regular audits of your practice's workload and working hours to ensure they align with the BMA's guidelines.
Training and Development: Provide ongoing training for all staff on safe working practices and the importance of adhering to these guidelines.
Feedback Mechanisms: Implement feedback mechanisms for staff and patients to identify areas of improvement and address any concerns promptly.