Consultation skills - Control the length of the consultation

Dr Mona Kular advises on the factors affecting consultation time that are within your control, including managing time effectively, keeping patients informed and dealing with multiple problems.

This article was reviewed on 11.1.18 by Dr Ravi Ramanathan.

Consultation times in general practice have increased over the years; the average length of a GP consultation in 2007/8 was 8.65 minutes, rising to 9.22 minutes in 2013/14.1 The average length of a UK consultation is shorter than many other European countries.2

Most surgeries book patient consultations at 10-minute intervals. Difficulties with time management and running late are common and can be stressful and frustrating for both patients and GPs.

With more complex health problems and the need to gather ever more information during consultations, it seems as though consultations are set to get longer.

There are a number of factors determining consultation length and various methods can be used to keep on track. Indeed, there is also some evidence to suggest that consultations do not have to be long in order for patients to feel satisfied.3

Factors affecting length

A number of specific factors have been found to increase the length of the consultation, including the presence of psychosocial problems and a positive attitude toward them by the GP.

New problems, city-based practices and female patients are also associated with longer consultation times.4 It would also seem logical that those presenting with multiple problems would increase the length of the consultation.

Being aware of these factors can enable GPs to pay more attention to time keeping and implement strategies to help time management.

Managing time effectively

Start as you mean to go on

Arriving at the surgery early will allow time to settle in, have a drink, check emails, start the computer up, prepare for the first patient and start the surgery on time.

Adjust your booking intervals

If you are currently working with consultation booking intervals of less than 10 minutes, it may be worth increasing to a 10-minute slot if you find that you often run behind or finish late.

Improve your IT skills

Battling with the computer is a sure way to slow you down. Make sure you are familiar with the system and aware of any shortcuts that can be used.

Learning to touch type if you can not already do so can also save a lot of time.

Keep patients informed

Many patients are unaware of the length of the consultation they have booked. Informing patients when they book or through a poster in reception will help with their expectations of the consultation.

They should also be informed that they have the option of booking a longer or double appointment if they have a number of things to go through.

Book appropriately

If there is a patient who you know always makes you run late who is booking a follow-up appointment, encourage them to do so at the end of a surgery so it does not affect the rest of your appointments.

Multiple problems

A 10-minute consultation is not long enough to satisfactorily deal with a long list of problems, unless they are each very minor, which is usually not the case.

It helps if you can try to identify early on in the consultation whether the patient has come about more than just one thing. Allowing the patient time at the beginning of the consultation, using open questions and picking up on non-verbal cues will help with this, as well as being direct and asking if there is anything else after the first problem has been presented.

The best thing to do when presented with a list of problems is to prioritise. Asking the patient which he or she considers to be the most important is one way of doing this, however sometimes it is clear that there is a clinical priority within the list.

Consider a polite way of asking the patient to reattend so that the other problems can be tackled. Most patients will be pleased that you want to spend time dealing with their problems effectively.

Ending the consultation

There are times when, despite the consultation clearly being over, patients continue to chat or prolong the consultation.

As long as the patient's needs have been met within the consultation, this is a time when breaking rapport is acceptable and necessary.

Ways to do this include breaking eye contact; altering your body position away from the patient; speaking faster and louder than the patient; sitting up straighter; handing over a prescription or patient information leaflet or starting to stand up. In some cases, it may even be necessary to stand up and open the door for the patient.5

Key learning points

  1. Consultation times have increased over recent years.
  2. Female patients, psychosocial problems, new problems and city-based practices all have longer consultation times.
  3. Prioritise problems when patients attend with a list.
  4. Be prepared to break rapport to end the consultation.

Dr Kular is a GP in Nottingham

Work through a case scenario based on this article and claim your certificate on MIMS Learning


  1. Hobbs R, Bankhead C, Mukhtar T, et al. The Lancet 2016; 387: 2323-2330
  2. Irving G, Neves A L, Dambha-Miller H et al. BMJ Open 2017; 7: 10.
  3. Jenkins L, Britten N, Barber N et al. Consultations do not have to be longer. BMJ 2002; 325: 388.
  4. Deveugele M, Derese A, van den Brink-Muinen A et al. Consultation length in general practice: cross sectional study in six European countries. BMJ 2002; 325: 472.
  5. Moulton L. The Naked Consultation: a practical guide to primary care consultation skills, 2nd edition. CRC Press, January 2016.

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins


Already registered?

Sign in

Follow Us:

Just published

Labour promises 5,000 GP training posts and premises boost in £26bn 'NHS rescue plan'

Labour promises 5,000 GP training posts and premises boost in £26bn 'NHS rescue plan'

The Labour party has promised a £26bn real-terms increase in NHS funding by 2023/24...

Can GPs believe the Conservatives' promise to deliver 6,000 more GPs?

Can GPs believe the Conservatives' promise to deliver 6,000 more GPs?

In the run-up to the 2015 general election, then health secretary Jeremy Hunt promised...

PCN recruitment scheme 'disadvantages innovative practices', LMCs warn

PCN recruitment scheme 'disadvantages innovative practices', LMCs warn

Innovative GP practices are 'disproportionately disadvantaged' by the funding scheme...

GPs demand power to close lists and drop home visits amid workload crisis

GPs demand power to close lists and drop home visits amid workload crisis

LMCs will set out major concerns over practice workload later this month, highlighting...

GP services disrupted as floods cause havoc

GP services disrupted as floods cause havoc

GPs have been left battling to get into work and deliver services, with some finding...

GMC warning for GPs working for online services

GMC warning for GPs working for online services

A set of principles aimed at helping GPs and other health professionals who practise...