Increasing workloads for GPs and nurses are unsustainable, and general practice in England could be reaching saturation point, a new study published in The Lancet has suggested.
Researchers from the University of Oxford analysed over 100 million GP and nurse consultations at 398 general practices in England between 2007 and 2014 – equivalent to 4.5 percent of all GP practices in England – and found that the workload in general practice has increased by 16 percent.
The greatest increase was in GP telephone consultations which have nearly doubled since 2007. Although telephone consulting was introduced to help cope with rising workloads, the authors question whether the time involved (60 percent of the time a face-to-face consultation would take) and the fact that about a third of call result in a face-to-face consultation means the strategy will actually help to manage demand.
Average consultation times in general practice in England have also increased by 5 percent from 8.45 minutes in 2007 to 8.86 minutes in 2014. The authors warn that as consultation times gradually approach the 10 minute allocated slot, doctors and nurses have very little time in between seeing patients to fulfil other duties.
"For many years, doctors and nurses have reported increasing workloads, but for the first time, we are able to provide objective data that this is indeed the case," says Professor Richard Hobbs, lead author from the Nuffield Department of Primary Care and Health Sciences, University of Oxford. "As currently delivered, the system seems to be approaching saturation point.”
He adds: ”Current trends in population growth, low levels of recruitment and the demands of an ageing population with more complex needs will mean consultation rates will continue to rise. There are few short term solutions, but reducing the time doctors need to spend on non-clinical duties may help ease the workload temporarily. More research is urgently needed to fully estimate the knock-on effects of increased workloads in general practice on other sectors of the health system."
Dr Maureen Baker, Chair of the Royal College of GPs, says: “This report should ring alarm bells for the Government and spur ministers into action to address the crisis in general practice before it’s too late. For too long GPs have been expected to do more and more for less and less and this perfect storm of rising demand, plummeting resources, and not enough GPs can no longer be ignored."
