Family doctors should extend the 10-minute consultation time for patients who are most in need to improve care and increase their job satisfaction, a review claims.
Rising demand and falling GP numbers means the primary care system is ‘fragile’ and ‘verging on the unmanageable’, experts say.
Patients often struggle to get appointments and are being put at risk by hurried consultations, an interim report into general practice found.
Dr Nigel Watson, who is leading the Government review, said changes to the 10-minute consultation time was one of a number of areas that should be explored to alleviate pressures on the health sector.
But Dr Watson warned increasing consultation length would inevitably exacerbate difficulties in getting an appointment in the first place.
‘You’ve got fewer quick, easy appointments and more complex ones, meaning the working day is getting longer, the workload you’re coping with is greater – and the prevalence of disease is higher,’ he told GP magazine Pulse.
‘Clinically, GPs are expected to pick up more and more work, and with the focus on improved access, other things are compromised.’
In his interim findings, Dr Watson said NHS leaders must find ways to make GP partnerships more attractive to doctors entering the medical profession.
He suggested demands for more flexible working patterns meant younger generations were turning their backs on becoming partners, once seen as a prestigious position to aim for.
Instead, more are turning to locum work so they can choose to work part time and cut down on less appealing aspects like paperwork.
Posts for newly-qualified GPs offering a mixture of general practice, a chance to develop an interest in clinically-relevant specialties, and exposure to partnerships may encourage more to go into general practice.
Older GPs, who are increasingly retiring early, also need to be given incentives to stay in the profession for longer, perhaps by becoming mentors to those new to the role, the report suggests.
GPs reported that they were regularly working 12 to 14 hour days, and having to make many rapid clinical decisions and complex assessments.
The report said this was not sustainable and is contributing to the rising level of stress, burn out and wider mental health problems in general practice.
The average consultation time of 10 minutes in the UK – thought to be the shortest in the developed world – is contributing to this, it found.
And the number of appointments rose by nearly a quarter in the past five years.
Doctors say there are growing numbers of patients with complex conditions that cannot be dealt with in the normal 10-minute consultation.
The report notes: ‘A 10-minute appointment is not a contractual requirement, however, the reality GP Partnership is that longer appointments will result in a reduced number of available appointments offered or the individual has to work longer hours.
‘The chair will work with DHSC [the Department of Health and Social Care], NHS England, the RCGP [the Royal College of GPs]and the GPC [the BMA’s General Practitioners Committee]to consider how we can best support practices in bringing in changes to appointment length, where this is appropriate, to support different ways of working.’
Professor Helen Stokes-Lampard, chairman of the Royal College of GPs, said: ‘Our ageing population means that more patients are inevitably developing more than one long-term condition and requiring multiple medications to manage this, making the standard 10-minute GP appointment increasingly inadequate.
‘The RCGP has been saying for several years that GPs want to spend more time with those patients who need it most and we support the requests in this report.
‘However, this simply isn’t possible for most GP surgeries with current pressures, not least the severe shortage of family doctors.
‘There is a massive demand for appointments already and to immediately move to offering longer appointments would inevitably mean offering fewer in the short term, until we have more GPs and more members of other healthcare professions working alongside us to deliver care.
‘We are looking to NHS England for greater resources to help GPs and our teams deliver the best care possible for our patients, and hope that the support for longer GP appointments outlined in the interim GP Partnership Review report will move us another step closer.’