Fifteen-minute GP consultation will be bare minimum by 2030, warns RCGP

GP consultations will last at least 15 minutes by the year 2030 according to an RCGP report that highlights a profession under rising strain and calls for better funding and support to safeguard its future.

Professor Helen-Stokes Lampard (Photo: Pete Hill)
Professor Helen-Stokes Lampard (Photo: Pete Hill)

GP workload has soared over the past 10 years, according to a report setting out the RCGP's vision for the profession - Fit for the future: A vision for general practice.

Citing evidence that clinical workload increased by 'at least 16% between 2007 and 2014' while numbers of full-time equivalent (FTE) GPs per 1,000 people fell by 5% between 1996 and 2016, the RCGP warns that general practice is 'currently under huge strain'.

Prevalence of long-term conditions is rising - half of GP appointments are now for patients with at least one chronic condition. As a result, GPs deal with two and a half different issues on average per patient visit, in 'some of the shortest GP consultations amongst economically-advanced nations'.

GP funding

The college calls for 11% of the NHS budget to be spent on general practice, with extended GP training, an expanded GP workforce in modernised premises, with better IT infrastructure and supported by a 'step change in the capacity, capability and knowhow of general practice to undertake research and drive innovation'.

It also predicts that over the next decade patient records will be updated 'into a personalised data dashboard' available to health professionals across multiple NHS settings, including 'data from the patient’s genomic profile and wearable monitoring devices'.

Primary care networks will evolve into ‘wellbeing hubs’, with 'expanded teams offering a wider range of services, both clinical and non-clinical – and that access will increasingly be via digital and video channels'.

The development of 'micro-teams' within larger primary care units will maintain continuity of care, while resources and people will be shared across networks. The college also envisions 'greater use of artificial intelligence (AI) to improve triage systems that assess the severity of a patient’s health needs, enhance diagnosis, flag "at risk" patients, and safely identify the most appropriate care pathway'.

10-minute consultation

RCGP chair Professor Helen Stokes-Lampard said it was 'abundantly clear that the standard 10-minute appointment is unfit for purpose'.

'As GPs we want to deliver truly holistic care to our patients, considering all the physical, psychological and social factors potentially impacting on their health,' she said. 'But this depends on us having more time to spend with patients, and the resources and people to allow us to do this.

'Without more resources and an expanded workforce, longer consultations would simply mean increased waiting times, undermining patients’ ability to access the care that they need.'

The RCGP has pledged to drap up a roadmap for each of the four UK nations to set out what needs to be done to realise its GP vision.

Five-year contract

Professor Stokes-Lampard said: 'Things are incredibly tough at the moment for many working in general practice, but we have had promises of more funding, resources and GPs across the UK, a new five-year GP contract in England promising to ensure money gets to the front line of patient care, new contracts in Wales and Scotland, and new state-backed indemnity schemes in England and Wales.'

Implementing these promises alongside the RCGP vision could usher in the 'dawn of a new era' for general practice, she added.

BMA GP committee chair Dr Richard Vautrey said: 'As more and more patients live with a number of complex conditions, GPs are increasingly concerned that short consultations with their patients are rarely conducive with providing the high level of care that people expect and deserve. This unreasonable time pressure also has a major impact on the mental wellbeing of doctors.

'No GP wants to rush their time with patients, squeezing it into a 10-minute window when it needs far longer, but they are forced to do so by the sheer volume of workload they are faced with. While it is for practices to determine how long their appointments should be, the BMA wants them to have the necessary resources and workforce capacity to be able to dedicate appropriate time to each patient and set their own safe workload limits.'

An NHS England spokesperson said: 'The NHS long-term plan means an extra £4.5bn is being invested in primary and community care, alongside the recruitment of 20,000 physios, therapists and other health experts to offer patient more access to specialist care in GP teams, building on success in the last year alone which has seen GPs across the country free up an extra half a million hours of time for patients.'

A DHSC spokesperson said: 'Last year a record 3,473 doctors were recruited into GP training and the new five-year contract for general practice will see 20,000 more staff working in GP practices – helping free up doctors to spend more time with the patients who need them.

'The vision reflects many of the commitments in the long-term plan on the future of general practice, backed by an extra £4.5bn more a year for primary and community care by 2023/24.'

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