Dr Chris Mimnagh: There is no one-size-fits-all for GP workload limits

Workload is a hot topic - it always is in winter, but this year perhaps more so given the pressures across the NHS.

In general practice we have been dealing with increasing workloads in recent years. So, is there such a thing as a 'safe' workload in primary care?

The BMA consensus is that 25 15-minute consultations a day is a safe limit. Clearly most of us GPs in the UK see more patients than this and leaders in general practice use this mismatch to support calls for extra investment.

None of this is wrong, but life is seldom as simple as a one-size-fits-all number for safety.

In our practice we have a range of characters, skills, interests, personalities who all combine together to produce a vibrant team. I’m a fairly slick consulter, happy with semi-acute, children and bowels, with a passion for information.

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I can exist because for my yin, there is a yang, Hilary is thoughtful, compassionate, is interested in women’s health, mental health and is by no means a quick consulter. She retires in a month and I will miss her greatly.

Overall our practice has a six-minute average phone consultation length and a 15-minute face-to-face consultation average length.

We know that a string of over 22 phone consults results in a change to our decision making and requires a break. We try to stay aware of our personal pressure and that placed on our colleagues.

As a part-timer I have the option to do more clinical work in the winter, less in the summer. Over the year I’ll work hard and less hard. It seems the right thing to do.

So what’s my point?

Simply put - there is no ‘safe’ figure, patient type, physician preference, seasonal changes all combine to obfuscate a single value.

There is, however, the feeling of pressure. Knowing your own resilience, awareness of your health, physical and mental, the actual requirements of your role and the support and needs of colleagues is the undefinable safety factor in primary care.

So, sit back for a moment, breathe, recognise your stressors and strengths and take heart, summer is coming.

  • Dr Chris Mimnagh is a GP in Liverpool and head of clinical innovation liaison and deployment at The Innovation Agency, the academic health science network for the north-west coast.

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