RCGP urges half-hour consultations to improve long-term conditions care

GPs should roll out care planning and 30-minute consultations to help patients with long-term conditions to better manage their health, the RCGP has said.

Guidance from the college urges GPs to increase patient involvement in decisions about how to better self-manage their condition to improve health outcomes and save the NHS time and money.

GPs will need to allot 30 minutes to each care planning consultation to accommodate the new approach, according to East London GP and diabetes lead Dr Isabel Hodkinson, who co-authored the guidance.

The guidance, Care Planning – Improving the Lives of People with Long-Term Conditions, was launched by RCGP chairwoman Dr Clare Gerada on Wednesday.

Dr Gerada told attendees at the London event: ‘Patients with long-term conditions don’t want to have their lives dictated by their condition.

‘The more we can use the expertise of patients, the easier it will be to manage their condition.’

She said GPs will ‘have to change the way they work over the next few years’ as long-term conditions increase in prevalence.

At least 15.4 million people live with long-term conditions in England and the figure is expected to rise to 18 million by 2025.

These patients already account for the majority of GP consultations.

The RCGP guidance aims to help GPs shift their focus from telling patients what they should be doing, to ‘enabling’ them to influence their own care.

Central to the concept is the creation of a care plan, which lets patients set their own, achievable goals for how to improve their health.

Dr Sue Roberts led the Diabetes UK ‘Year of Care’ Programme that demonstrated the approach from 2007-10.

Sending test results to patients one to two weeks before the consultation was a key first step in the process, she said.

Dr Roberts said not sharing this information with patients beforehand would make for a less productive consultation, and likened it to ‘going to your bank manager for a loan without ever having seen your statement’.

She said changing GPs’ attitudes to patients with long-term conditions was a challenge but improved job satisfaction in pilot practices.

RCGP vice chairman Professor Nigel Mathers, who chaired the work on the guidance, said he hoped clinical commissioning groups would commission enhanced services for care planning and that NICE quality standards could be developed in this area.

Patient David Bumby said the approach made him feel more in control of his type 2 diabetes. ‘I, as the patient, set the agenda with a number of points I want to cover during the consultation. It means the time is well spent, working to the priorities of the patient, not the healthcare professional.’

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