GP appointments should be five minutes longer, says BMA

GP appointments should be extended to 15 minutes because an ageing and increasingly overweight population means that many patients need extra time at the doctors’ surgery, according to the British Medical Association (BMA).

The standard slot currently stands at 10 minutes but the BMA GPs committee (GPC) believes that increasing the length of appointments by 50% would allow for improved decision-making and service, as well as reducing the administrative burden for doctors outside clinic hours.

In order to lengthen the contact time, the BMA says, in a report published on Monday, there should be a reduction in the number of patients each GP has to see every day. Dr Brian Balmer, who is on the GPC’s executive team, said: “In a climate of staff shortages and limited budgets, GP practices are struggling to cope with rising patient demand, especially from an ageing population with complicated, multiple health needs that cannot be properly treated within the current 10-minute recommended consultation. Many GPs are being forced to truncate care into an inadequate timeframe and deliver an unsafe number of consultations, seeing in some cases 40-60 patients a day.”

He said this was well above the 25 consultations a day recommended in many other EU countries. “We need a new approach that shakes up the way patients get their care from their local GP practice,” he said.

Until April 2014, GP appointments in England were fixed at 10 minutes. The requirement was dropped following a negotiation with doctors’ leaders. The length can be varied but it remains the standard: the NHS Choices website tells patients they should expect doctors to spend an average of 8-10 minutes with them.

Based on a widely accepted formula of 72 appointments per 1,000 patients each week and an average list size of 1,600 patients, the report, Safe Working in General Practice, proposes that GPs should be offering 115 appointments a week – an average of 23 a day over five days.

The committee is not suggesting doctors suddenly slash the number of appointments but said the health service should be aiming for this target to enable patients to get proper care. Its members did say more government money would be needed to fund longer appointments but did not say how much – although the likely expense will make the idea of longer appointments difficult to achieve.

Dr Zoe Norris, a GP locum, said the current 10-minute appointment might be just enough for a fit and healthy patient with a single condition but even then the time taken for them to enter the room, talk about their problem and then be examined added up. “As soon as you throw anything unusual into the mix you’re scuppered,” she said. “That might be you have got a complex patient, you might have a patient who needs help getting undressed. There’s no time to do the preventative things you need to do. It’s heartbreaking. I feel as though I’m doing half a job.”

Nevertheless, she said there was a reluctance to cut patients short, which led to GPs working 14-hour days.

The GPs committee said it would be possible to achieve greater efficiencies, helping fund longer appointments by linking together several surgeries into hubs, allowing them to work together to manage demand.

A report by the NHS Alliance and Primary Care Foundation published last year estimated that 27% of GP appointments could be avoided through greater integration, use of a wider primary care team and improved administration.

But Balmer is adamant that increased government funding will still be necessary. “More GPs must be put in front of patients so that the number of consultations per GP a day falls to a sustainable level,” he said. “General practice cannot be allowed to continue being run into the ground: it’s time for positive change that gives patients the care they deserve.”

An NHS England spokesman emphasised it no longer required appointments of a fixed length: “How long to allocate to individual patient appointments is at the discretion of individual GP practices, based on patient need, and there are no national limits suggesting 10 minutes should be the norm,” he said.

GP appointments should be five minutes longer, says BMA