The must-read stories and debate in health policy and leadership.

The summer has been littered with stories of demand making accident and emergency unsafe, driving worrying delays in the ambulance sector. Throughout this, the demand on primary care services has also been made clear. However, it is not often that data on the safety threat of this demand on primary is shared.

Yesterday HSJ revealed data from Modality Partnership, one of the largest GP groups in England, showing its GPs are now regularly breaching daily “safety levels”.

It showed the average number of patient contacts per day, which could be face to face or phone consultations, had increased from just over 20 to almost 50. The “safe” number of patient contacts recommended by the British Medical Association is 25 to 30.

What happens when a GP hits an “unsafe” workload? One of the biggest issues is the potential to miss things in patient diagnosis. This could lead to serious underlying health issues being left untreated or misdiagnosed. One GP said: “There is just so much to cover – I am worried about missing something.”

The warning seemed particularly concerning as it was coming from a large-scale provider of primary care, which is more likely to have the resources to support its GPs with an unsafe workload. What is likely to happen to those individual single-hander practices which are also struggling?

Digital maturity grows up

NHS organisations which “game” the digital maturity assessment system to win funding might find that the game is nearly up.

A new set of ratings is being drawn up with the aim of replacing the current self-assessment with a process of peer review against seven key measures of maturity.

The plans have been set out by NHSX, alongside proposals to devolve more technology funding from central bodies to integrated care systems.

Chief executive Matthew Gould told HSJ: “The previous assessment was a self-assessment and inevitably across the system people saw a connection between how they filled in the assessment and what dollop of cash they were going to get from the centre.

“So, I don’t think it became a faithful representation of where people actually were…

“The way we’re doing it now is obviously quite different. It will, I hope, rely quite heavily on peer review.”

Read Lawrence Dunhill’s full story here.