Exclusive: GPs in England deliver 1m appointments per week over 'safe limit'

GPs in England deliver over 25% more appointments per week than a safe limit proposed by the BMA, analysis by GPonline shows.

GP leaders have warned that patients are being put at risk by soaring workload, with doctors forced to provide large numbers of appointments per day increasingly tired and at higher risk of making mistakes.

NHS England estimates that GPs provided more than 5m appointments per week in 2015/16.

The latest official workforce data show that England has 34,495 full-time equivalent (FTE) GPs, suggesting that each FTE GP delivered on average 145 appointments per week. Many GPs are delivering far in excess of this, with a GPonline poll last year revealing that one in eight partners had delivered 70 consultations or more in a single day on at least one occasion in the previous year.

GP workload

However, BMA guidance on safe working published in 2016 makes the case that 115 appointments per week should be seen as the 'quantified commissioned activity of an NHS GP'.

If each of the 34,495 FTE GPs provided 115 appointments per week, this would give a total supply of just under 4m appointments - more than 1m short of the total NHS England says is delivered each week by the GP workforce.

GPC deputy chair Dr Richard Vautrey told GPonline that soaring GP workload was putting patients at risk. 'It's putting patients at risk because of the huge workload they are having to carry, and the more consultations per day, the more tired you become and the higher the risk of mistakes.'

Last year, a BMA poll found that more than eight out of 10 GPs say their workload is unmanageable, prompting a warning from Dr Vautrey on this website that general practice across England was 'buckling' under the strain

The 115 appointments per week proposal is based on lengthening appointments to 15 minutes each, amid concerns that rising complexity in the patient population many GPs are managing means that 10-minute consultations are simply inadequate.

Dr Vautrey said: 'Patients are not getting the input they often need because the problems they are living with can't be dealt with in the confines of a 10-minute consultation.'

GP access

He added that it was hard to be precise about the gap between numbers of appointments delivered by NHS GPs and safe capacity, partly because the NHS England figure for total appointments was an 'extrapolation'.

But he said the estimate of 5m appointments delivered per week fits with the 'year-on-year rise that many GPs feel is the reality of general practice' and that reducing this number by a fifth was a sensible goal.

'This is why we have been saying for the past few years that urgent steps need to be taken to protect GPs from rising workload and burnout.'

The BMA published detailed proposals last year for 'overflow' services to be established in CCG areas to ease pressure on general practice and allow them to bring down the number of appointments they deliver each week.

LMC leaders have also backed calls for a cap on the number of appointments GPs can deliver per day to reduce 'suicidal' pressures on general practice.

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