Exclusive: GPs call for consultations to be capped at 30 per day to ease workload

Almost two thirds of GPs say the NHS should cap the number of consultations they can provide per full working day at 30 or less, a GPonline poll suggests.

A total of 43% of GPs backed a cap of 21-30 consultations per day, with a further 20% backing a limit of 20 consultations per day or less, the poll found.

The findings come as GPs prepare to meet in London on Thursday at the LMCs conference 2016, with workload - and a potential consultation cap - at the top of the agenda.

A cap would pose a significant workforce challenge to general practice and the NHS, with many of the 369 GP respondents reporting current workload in excess of the limit they would like to see.

GP workload

A total of 28% of GP respondents said they deliver 21-30 consultations on average per clinical session - equivalent to 42-60 per full working day. More than two thirds of GPs - 69% - said they deliver 11-20 consultations per clinical session - equivalent to 22-40 per full day.

Research cited by the RCGP suggests more than half of GPs carry out 40-60 consultations per day.

A key debate on Thursday at the LMCs conference 2016 will consider calls to 'set a national standard for a maximum number of patients that GPs, nurses and other primary care professionals can reasonably deal with during a working day to maintain delivery of a safe and high quality service'.

The BMA called for this measure among recommendations set out in its Urgent prescription for general practice published earlier this year.

Meanwhile, at the special LMCs conference in January, GP leaders voted for the GPC to negotiate restrictions on the number of patient contacts allowed each day per GP to 'a level comparable to other EU countries'.

Cap on consultations

GPC deputy chairman Dr Richard Vautrey told GPonline that a 30-consultation limit would not simply address workload, but 'would reflect the equal desire for longer consultations too'.

'If you were to do 15- or 20-minute consultations you would have fewer consultations, although they would be better,' he said. But he warned: 'The real challenge then is how do you meet the insatiable desire for access and general practice appointments.

'That has been the issue over the past decade, not enough people, slots and hours in the day to provide that, and that is why we are getting this call for a safe, reasonable and clinically appropriate level of appointment provision.'

Dr Vautrey acknowledged that implementing a cap would be complex. He said practices would be wary of a national limit that invited micromanagement of how they operate, but also of a more flexible benchmark that might be ignored.

But he added: 'I don't think a cap is too difficult [to acheive]. It is what people are calling for - we need to work with [the RCGP] and see how it could work. We would need more GPs, but also a wider expanded primary care team. We have to look at the wider workforce, and crucially we need resources to support that.'

GP funding

The GP Forward View published last month by NHS England set out a series of measures to address GP workload.

It outlined plans for a £30m plan to release capacity in general practice, contract measures to 'stop work shifting at the hospital/general practice interface, a £40m practice resilience programme, and a slimmed down CQC regime among other measures.

Photo: iStock

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