The examples below are illustrative only. They are not intended to define the right approach for any practice, but to demonstrate how the principles described in this guidance might be applied in different settings.
Example 1: Reducing invisible work in an urban practice
A larger urban practice has concluded that the greatest threat to sustainability is not the number of consultations being delivered, but the accumulation of work surrounding them. Results management, prescribing queries, workflow, supervision and clinical correspondence are all consuming significant amounts of unrecognised time outside of contracted hours.
Rather than redesigning the entire service, the partners might begin by making one indirect-clinical-care session available within the weekly rota. They may also clarify ownership of incoming workflow and review how supervisory responsibilities are distributed across the team.
After a trial period, the practice assesses whether backlogs have reduced and whether clinicians are working less frequently beyond planned hours. If successful, the changes become part of the routine working model and inform wider discussions about workload distribution.
Example 2: Building resilience in a rural or remote practice
A rural, island or remote practice faces different challenges. Clinical scope in this instance is broader, workforce recruitment more difficult and access to wider system support more limited.
In this context, sustainability may depend less on increasing capacity and more on protecting organisational resilience. A practice uses this guidance and determines that key responsibilities are concentrated in too few individuals, that urgent work regularly disrupts planned activity, and that business and governance functions are receiving insufficient attention.
The resulting changes may be relatively modest. Making responsibilities more explicit, protecting time for essential non-clinical work and developing clearer contingency arrangements may nevertheless reduce organisational fragility and improve resilience over time.
Example 3: Using new investment to reshape GP time
As additional investment becomes available, practices may wish to consider how new resources can support sustainability rather than only increase activity.
A practice might choose to use additional capacity to make leadership, supervision or quality-improvement time protected within GP working patterns. Others focus on reducing dependence on work undertaken beyond scheduled hours by building in sufficient time for non patient-facing work in work patterns.
The key question is not simply whether a practice can do more, but whether it can organise the whole job more honestly and sustainably. In many cases, investing in protected time for leadership, supervision and development will improve patient care just as effectively as increasing appointment capacity alone.
Example 4: Realising BMA safe workload limits
GPs in a practice are routinely providing more than the BMA and European recommended safe limit of 25 clinical contacts per day. While this limit can vary with the complexity of cases dealt with, clinical workload pressures in this practice are risking burnout in the GPs.
With the help of their Practice Manager, GPs change the appointment system to ensure daily appointments per GP do not exceed this, by balancing the types of appointments and ensuring all work is listed on the appointment screen. They may utilise the new workforce funding to employ additional GP hours to ensure increasing practice capacity also means that individual workloads are now sustainable, creating longer term stability within the team.