COVID-19: GPs and workload prioritisation discussion and resource

25 March 2020

RCGP Chair Martin Marshall's latest message on COVID-19 and what the College is doing to support members with workload prioritisation.

Workload prioritisation guidance during COVID-19

Learn how to set priorities in general practice in the RCGP Guidance on workload prioritisation during COVID-19 (273 KB PDF).

Vlog post transcript

Dr Steve Mowle: I'm Steve Mowle with Martin Marshall, our RCGP Chair. The College is producing a suite of practical guidance on our COVID-19 hub and today’s vlog is about our guidance on workload prioritisation. Martin, why was it important for the College to issue this guidance?

Professor Martin Marshall: Hi Steve. So, you we know that there's been a long-term challenge with workload in general practice.  We know that we need to do something radical during this COVID crisis, so that we can look after patients who are sick, particularly at a time when we know that our teams are often reduced by self-isolation and by illness. 

The College has been working with NHS England and with the BMA in order to produce guidance, which essentially says what we should continue doing and what should we stop doing. 

This is really important, so that we can create space to deal with the crisis, particularly as the crisis deepens, so that we can focus on those with greatest need, and also so that we can minimise the risk of other non-COVID conditions - we have to remember that they still exist - from getting worse. We know from previous epidemics that when you focus on an epidemic, other health problems can deteriorate at the same time.

Dr Steve Mowle: Okay, so what does the guidance look like? 

Professor Martin Marshall: Well, it's a very simple table with three groups. The green category is things that we should carry on doing. The amber category is things that we can do if we've got space to do them at a local level. The red category is the things that we should stop. 

So, as examples, in the green category, we should continue to assess people who think they are unwell, make an initial assessment. We should be investigating people who have serious illness, particularly cancer of course. We should absolutely be continuing our immunisations for children and people with long term conditions, and we should be managing unstable long-term conditions. Of course, all of those, where possible, should be done remotely. 

In the amber category, we should be doing less of monitoring low risk medications, unless we've got time to do it, and providing care for stable long-term conditions. Again, if we've got time to do it great, but, if they're stable, they're not a top priority.

In the red category, things that we should stop include managing minor self-limiting conditions, doing things like minor surgery, routine medicals, routine data collection and, of course, not having to engage, except in exceptional circumstances, with CQC inspections, and with appraisal as well.

The details of all of these areas are on the College's COVID website. Please remember, of course, this is guidance only. Use your own clinical judgement. We're really keen to have feedback from members about whether this list is right, how we might improve that list, what you’re doing at a local level that might be good practice that you want to share.

So, if you've got any feedback at all, please do so via the COVID email, which is on the website, or by joining the new discussion forum which has been established by our President, Amanda Howe. 

Dr Steve Mowle: Sounds great. It's a really difficult time for our members at the moment. Are there any silver linings from this piece of work, do you think?

Professor Martin Marshall: I think there are, you know. COVID is a dark, dark cloud but there are some silver linings and I guess it's our job as professionals to find those and to make sure that they become a reality in the future, when we are beyond this particular crisis. 

In the case of workload, for example, there are things that we do, particularly administrative things, that we really don't have to be doing, that add little value. So, let’s really focus on those when the crisis is over and make sure that we don't reintroduce things that are unnecessary. 

The other area of course, is particularly around managing self-limiting conditions. Patients will learn how to self-care with a little bit of support and help from us and a lot of support from online resources. Let's encourage and support that and continue that when the COVID crisis is over.

Dr Steve Mowle: Brilliant. Thanks Martin. We'll be back soon and take care out there.


Contact us

RCGP members can email our dedicated Covid-19 inbox with feedback and questions.

Email: Covid19@rcgp.org.uk

Latest updates

Have a look at our dedicated Covid-19 page.


Vlog discussion with 

Professor Martin Marshall, Chair of the RCGP Council

Professor Martin Marshall is a GP in Newham in east London and Professor of Healthcare Improvement at UCL, Programme Director for Primary Care at UCLP Partners. He leads Improvement Science London, an initiative to promote and embed the science of improvement across the health service and academic sectors. 

Previously, he was director of research and development at the Health Foundation, Deputy Chief Medical Officer for England, and Director General in the Department of Health, a clinical academic at the University of Manchester and a Harkness Fellow in Healthcare Policy.

He has been a GP for 28 years. He is a fellow of the Royal College of Physicians of London and of the Faculty of Public Health Medicine and was a non-executive director of the Care Quality Commission until 2012.

He has over 200 publications in the field of quality of care and in 2005 he was awarded a CBE in the Queen's Birthday Honours for Services to Health Care.

Dr Steve Mowle, Honorary Treasurer of the RCGP

As Honorary Treasurer, Dr Mowle has responsibility for all matters relating to the College finances. He was Vice Chair of the RCGP from 2011 to 2013 and was the lead officer for Commissioning, GP Nursing, the RCGP Annual National Conference, Patient and Carer Partnership Group and GPC liaison. He has also previously chaired South London Faculty Board and RCGP London.

He trained in Wales and has been a GP Partner at the Hetherington Group Practice in South London since 2000. Dr Mowle has held a number of different educational roles including GP Trainer, Programme Director and most recently Associate Dean for HEE, with lead roles around recruitment and supporting trainees in need of support. He currently works as an RCGP International Tutor in South Africa.

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