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​GPs have almost twice the safe number of patient contacts a day

Exclusive GPs in the UK have an average of 41.5 patient contacts every day – 60% more than the number considered safe by European GPs – Pulse can reveal.

A survey of 900 GPs reveals that more than one in five GPs have more than 50 daily patient contacts, including face-to-face and telephone consultations, home visits and e-consultations.

Some GPs said they had up to 70 patient contacts a day – with others saying that the pressure has forced them to resign or give up partnerships.

However, a leading European GP forum has recommended no more than 25 contacts a day.

The BMA's GP Committee called for a limit to the number of consultations a GP carries out each day in its Urgent Prescription manifesto for general practice last year, but nothing has come of it.

A Pulse investigation last year revealed that patient demand is increasing at the same time as the number of GPs is decreasing – meaning GPs will have to work an extra two hours a day to meet demand by 2022.

The comments from GPs suggest that they are seeing an unsafe number of patients. They include:

  • One GP in East Anglia, who said a typical day included 42 contacts with 30 or calls as duty doctor in the afternoon, which could soar to 50 plus phone calls on ‘bad days’. They added: ‘I have actually tendered my own resignation as it is making me unwell to work at this pace.’
  • Another doctor, who reluctantly left 13-14 hour days as a partner for a more manageable workload as a salaried GP and 31-40 daily contacts and told Pulse: ‘I felt I was at a risk of making mistakes and causing potential harm to my patients and my career.’
  • One GP told Pulse that on one exceptional ‘horrendous’ Monday he had 71 contacts. Since then the practice has since increased the number of on-call doctors on Mondays to three.

GPs reported that dealing with letters, lab work, repeat or acute prescriptions and referrals can mean they are dealing with case work for five times as many patients as they see.

Shropshire GP and vice-president of the European Union of General practitioners (UEMO) who has surveyed doctors across the continent said: 'Around twenty-five contacts is safe.’

She said the higher numbers of contacts in the UK ‘is pretty dreadful’. She added: ‘I think GPs have little insight into how hard they are working.’

Dr McCarthy said: ‘The demand is fuelled partly because patients are pushed to the GP for any problem there is.’

She said doctors across Europe told UEMO they 25 contacts was suitable, with 25-30 minute appointments as standard in some countries.

The BMA voted at this year's Annual Representative Meeting that there should be a set limit of GP-patient contacts per day, but did not vote on a number.

Dr Richard Vautrey, BMA GP Committee chair, said: 'We know that unmanageable and unsafe workload is the primary reason behind doctors leaving general practice, which is leading to serious issues including practices closing to new patients and other surgeries closing entirely. This workload pressure also means GPs are increasingly suffering from burnout and patients are being put at risk of unsafe care.

'The BMA has called for practices to be empowered to set their own capacity limits for safe working, which includes limiting the number of consultations per day. Fewer consultations would mean longer contact time with patients, leaving doctors better able to ensure safe, high-quality care, that many feel is not possible within the current 10-minute consultation.'

Professor Helen Stokes-Lampard, chair of the RCGP, said: 'This survey backs up what the College has been saying for years – that many GPs and our teams are regularly working way beyond what could be considered safe for patients, and potentially jeopardising our own health and wellbeing.

'GPs expect to be busy, and we are making more consultations than ever before as we strive to deliver the best possible care to all our patients who need it, but the workload at the moment is relentless and it’s taking its toll. The GP health service in England was launched earlier this year, and there are already more than 1000 GPs on its books.'

Survey results in full

On average, how many patient contacts (including consultations, telephone, home visits and e-consultations) do you have in a full day in clinic?

0-10: 1%

11-20: 3%

21-30: 9%

31-40: 37%

41-50: 29%

51-60: 13%

61-70: 4%

71-80: 2%

81-90: 0.5%

91-100: 0.1%

More than 100: 1%

Don’t know: 0.3%

The survey was launched on 10 October 2017, collating responses using the SurveyMonkey tool. The 25 questions asked covered a wide range of GP topics, to avoid selection bias on one issue. The survey was advertised to our readers via our website and email newsletter, with a prize draw for a Ninja Coffee Bar as an incentive to complete the survey. A total of 899 GPs answered this question.

Readers' comments (45)

  • Poor working conditions;blaming the doctors for everything,revalidation, poor pay.
    I am not surprised. I dont think doctors have any other option but to leave!!.

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  • I agree a legal maximum is needed, but once it is reached, then what? Also those European averages are odd: 25 x 25m is 10.4 hours of patient contact per day.

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  • Weasel word from the RCGP and the BMA what have they actually done over the last decade apart from preserve the cult of the NHS to the cost of their members.They shouldn't be surprised when those members turn their back on them as well.It says something when you now need a reference to get off the GMC register before they allow you to leave,as from a recent retirement form our practice.When the ship is sinking you wont stop those sensible enough and able to from abandoning it.

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  • THE TORIES ALWAYS GO ON ABOUT THE NHS SHOULD BE MORE LIKE "AIRLINE SAFETY" CULTURE BUT UK PILOTS ARE NOT FORCED TO FLY TWICE AS MANY HOURS AS EUROPEAN PILOTS ARE THEY !

    AIRLINES HAVE STRICT REGULATIONS LIMITING PILOT WORKLOAD AND IF WE SHOULD COPY THIS CULTURE THEN WE MUST START IMPLEMENTING THE SAME MODEL.

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  • BUT THE POWERFUL MEDICAL ORGANISATIONS AND REGULATORS WON'T STAND UP TO THE GOVERNMENT !

    FORGET THE PERSONAL KNIGHTHOODS AND GONGS AND "DO WHAT IS MORALLY RIGHT FOR PATIENT SAFETY"...

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  • More than 25 contacts/day is fine. Let's be honest, the quick appts make up for the complex ones. It's hard to spend 25 mins with a verruca or an IGTN

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  • It's not just the contacts/day.
    It's the crushing burden of the 100s of patients poorly discharged from the completely underfunded secondary care services with GP to chase, GP to refer, GP to sort out, GP to follow up, GP to re-refer. Although we can send out standard letters to bounce this back it is legally hard to 'unknow' a potential cancer/renal failure/untreated infection once 'known', especially as often the patient has no knowledge of this, leaving the GPs paranoid as to what medico-legal clinical bombs are buried in the unnamed discharge letters and summaries that we might see the day after discharge or a few months later, but that regardless need close scrutiny and action.

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  • Macaque

    Money grabbing, greedy partners would not like the idea of limiting patient contacts to 25. Less number of partners in the partnership with many many patients registered seem to be the magic formula. LOL!

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  • trump-hole, trumfol NHS GP- we shouldn't let it into the country!

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  • There should be a set number of pt contacts that a practice should provide per 1000 pts. Once this level is breached for whatever reason be that poor discharges, GP to do more post discharge etc then it is the responsibility of the CCG to provide the extra capacity which can be in the form of a LES so that practices themselves can provide it if able. Until there is cost attached to the wider health economy of work coming our way it will keep coming.

    There needs to be an element of activity-based pay in our contract otherwise where is the incentive to change anything.

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