GP workload intensifies as practices head for tough winter

GP workload intensified sharply in the final two weeks of September with practices delivering 6% more consultations and a third more clinical administrative work than in the same period in 2019, GPonline analysis of RCGP data shows.

GP consultations (Photo: Robert Johns/UNP)

Including face-to-face, telephone, e-consultations and home visits, total appointments delivered by GP practices in the final two weeks of September 2021 were 6% higher than in the same period in 2019, before the pandemic.

Clinical administrative work - including tasks such as prescriptions and referrals - was 33% up, GPonline analysis of data from the RCGP's research and surveillance centre found.

The findings provide further evidence of the intensity of GP workload as the profession heads into what experts predict will be an extremely challenging winter for the NHS.

GP workload

They come after GPonline revealed last week that the time available for GPs to complete soaring levels of clinical administrative work - driven up by the backlog in NHS hospital care - has been cut back severely by a sharp fall in the proportion of patients who fail to attend appointments (DNAs).

Analysis of the RCGP data show that GP practices delivered around 71 extra appointments per 10,000 patients in the two-week period, an increase that would equate to around 1m extra appointments a month.

Although face-to-face appointments and home visits are down by around a third compared with before the pandemic, telephone appointments have increased by around 2.5 times. E-consultations are up by a similar amount - taking total appointments now well above 2019 levels.

The surge in workload comes as practices are delivering the largest flu vaccination campaign in NHS history, alongside COVID-19 booster vaccination for more than 10m eligible patients.

Face-to-face appointments

The figures come ahead of the 2021 RCGP annual conference - and just weeks after college chair Professor Martin Marshall warned MPs that face-to-face appointments on demand for all patients who want them was simply 'undeliverable' given current pressures on general practice.

Professor Marshall told MPs on the House of Commons health and social care select committee that general practice was facing intense pressure. He said practice teams were managing increased workload linked to the backlog of hospital care triggered by the pandemic, rising demand for consultations, increased complexity of care required in general practice and demands from the COVID-19 vaccination campaign and expanded flu jab programme, as well as an expansion of services over time in primary care.

Professor Marshall told MPs that 'somewhere from 5-10% more patients are being seen' in general practice now compared with an equivalent period before the COVID-19 pandemic - in line with the analysis by GPonline.

He added: 'In addition to that we are seeing much more complex problems in the consultations - the average consultation is 9.8 minutes, the average number of problems dealt with is now nearly three - so three minutes per complex problem we are dealing with in general practice - it is very difficult to deliver that.'

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