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According to the BMA, the UK GP-to-patient ratio is 1:2,285. That’s an increase of 348 patients per GP, compared to 2015. Since the pandemic, 97.5% of GPs report an increase in patient demand (MCG Healthcare Primary Care Survey 2022).
If surgeries are going to give appointments to every patient who wants one, then it’s only practical that those appointments will need to be short.
In the interest of fairness, each patient’s appointment with their GP is meant to last 10 minutes, but The Royal College of GPs has suggested that that is no longer fit for purpose. It suggests a standard 15-minute standard appointment length.
However, that might not get to the root of the problem. Whether appointments are 10, 15, 20 minutes or more, the allocation may be equal, but does that mean it’s fair?
One patient can approach their doctor with a sore foot, and another could present with complex mental health challenges, and a GP will theoretically spend the same time with each. Surely, though, relatively simple health complaints need less attention than more severe ones.
Here’s why the ten-minute appointment allocation may need a new approach.
The reality of primary care
While in theory, an appointment will be ten minutes long, in practice they will always vary. It’s hard enough to put a time limit on an interaction in any context, but in primary care sometimes the GP simply can’t provide the necessary care in such a short window.
NHS data suggests that nearly 1 in 5 appointments last over 20 minutes, and a third carry on for 15 minutes. In fact, only 48% keep within the 10-minute window. When over half of appointments last longer than allocated as a matter of course, it must be worth exploring alternative systems.
When surgeries allocate appointments based on the assumption that each will take 10 minutes, it will inevitably lead to frustration and disappointment for patients. It will also mean stress for practice managers and doctors, who are trying to deliver the best outcomes for patients, while operating efficient surgeries.
A better approach?
We’ve previously recommended some reforms to primary care appointments, and among those was a triage system. Aside from helping to decide when a patient needs to be seen, a medical receptionist could make an informed assessment about how long the appointment might need to be. When a patient presents themselves, the receptionist could exercise their judgement as to whether 10 minutes would be sufficient – but they would need the training and skills to make those judgements.
As we mentioned earlier, demand has never been higher, so how would GPs see all the patients who want appointments if some are going to be given longer?
Remote care may offer some extra efficiency. In-person appointments will always take slightly longer than those conducted over the phone or via video call, simply due to patients having to enter and leave the surgery and the doctor’s office. It’s not much for each appointment, but it adds up over days and weeks.
Also, the use of pharmacies may save 400,000 appointments every year. Alternative sources of care (for those who are willing and able to take them) could reduce demand to a point where some longer appointments are viable.
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