Reducing the time spent on bureaucracy: a survey of general practice 


The bureaucratic burden on GPs has grown in recent years.

The NHS Five Year Forward View, published in October 2014, identified the need for a ‘new deal’ for general practice, including through addressing workload pressures2. There is a consensus within the profession that bureaucracy must be reduced if general practice is not to buckle under the weight of paperwork. For example, in May 2015, the Royal College of GPs published a New Deal for General Practice3, which calls on the government to give GPs time to care, including by cutting red tape and bureaucracy.

In 2014/15 we surveyed more than 250 practice managers in England via a web-enabled questionnaire to uncover the burden of bureaucracy and elicit their thoughts about reducing this.

We asked about five key areas:

  • Getting paid
  • Supporting patients
  • Processing information from hospitals and providers
  • Reporting other information (for example to regulators, commissioners and tax authorities)
  • Keeping up to date (For example with safety notices, changing policies and procedures).

We wanted to know how much time managers spent on different activities, how burdensome they felt these were and what they felt were potential solutions. We also visited a number of practices to triangulate the findings and understand what might make a difference.



In brief, practice managers perceive that there is a high level of burden from bureaucratic processes and that this could be reduced substantially by employing simpler processes, streamlining and standardising communication between NHS organisations and by better use of IT and data sharing. Some of this is in hands of general practice but much lies under the influence of NHS England and CCGs.

Practice managers estimated that the most time consuming area, by far, was ‘Getting paid’ with nearly 140 hours a month estimated as spent on this activity.graph test

But interestingly, when asked which was the most burdensome area, only just over a quarter of practice managers identified ‘Getting paid’ with the other areas not so far behind.

Graph 3b

In the next five pages we have included some verbatim quotes of what practice managers told us about each area and provided a graph showing how frequently each intermediate level area was identified as the most burdensome and how we categorised the verbatim responses under each heading.