This site is intended for health professionals only

At the heart of general practice since 1960

pulse june2020 80x101px
Read the latest issue online

The waiting game

GPs spend fifth of consultation time on non-health problems

GPs are spending nearly a fifth of their consultation time dealing with non-medical issues at a cost of nearly £400m, according to a new report from charity Citizens Advice.

According to the study, A very general practice, GPs spend 19% of their time dealing with personal relationship problems, housing and unemployment concerns or work-related issues.

It also reveals that three-quarters of GPs say that the proportion of time they spend dealing with non-health issues as part of consultations has increased over the past year.

The report comes after former RCGP chair Professor Clare Gerada said she had referred more people to food banks than A&E in one week.

At the same time, NHS England is encouraging greater integration between social and health care, having given approval to funding ‘social prescribing’ pilot schemes.

GP leaders said that patients’ needs extend beyond ‘bio-medical’ healthcare, but this should not place greater burdens on GPs.

The charity surveyed 1,000 GPs in February this year on the effect of non-health problems on their workload.

The main findings included:

  • 80% report that dealing with non-health queries results in decreased time available to treat other patients’ health issues;
  • 64% report that non-health queries from patients increase the stress of their job;
  • 46% report that non-health issues raised during consultations contribute to increased costs to the practice and to the NHS;
  • 49% say these conversations help them better understand the communities in which they work;
  • 92% report that their patients had raised issues about personal relationship problems with them in the past month.

Citizens Advice has estimated that the basic financial cost to the health service of non-health demand on GPs is at least £395m, representing more than 5% of the NHS England budget for general practice and equivalent to the salaries of 3,750 full-time GPs.

The report said: ‘It is vital to say that this time (non-medical discussions) is not wasted. The GP-patient relationship is stronger for its breadth and should not become too narrow, not least because—as our own research confirms—there are complex links between health and wider social issues.

‘But if even half of the time we identify could be absorbed in other ways this would release 3.4 million hours of GP time and £200m; efficiency gains that could be reinvested in patient healthcare.’

Dr Sam Everington, a GP at the Bromley-by-Bow Centre in east London and chair of NHS Tower Hamlets CCG, who has been leading on the social prescribing referral pilots, said: ‘Patient needs in terms of education, environment, employment or creativity can be equally – or even more – important than bio-medical care in terms of health and wellbeing.

‘But we must recognise that we cannot place a greater burden on GPs. What we have found in Bromley-by-Bow is that having a referral form with a tick box so that we can refer patients to voluntary organisations like Relate for example, if the concern is about relationships, works because a social prescribing team then takes over. We refer patients to a whole raft of organisations such as Shelter and Citizens Advice. It’s all about connections.’

Readers' comments (6)

  • Where there's a will there's a way...but money is needed to fund it not everybody is willing to work as a volunteer

    Unsuitable or offensive? Report this comment

  • Today's request is for me to cut the patient's finger nails as she is diabetic and I am a "professional"!

    Unsuitable or offensive? Report this comment

  • Some of it can be time well spent if it enables a more holistic assessment and a better health and/or social care outcome but this time needs to be resourced
    Maybe the thrice spent better care fund could be utilised?

    Unsuitable or offensive? Report this comment

  • Not on my watch it doesn't. There is only one answer to the huge demands placed on us. Effective triage and signposting of patients. That or a co-payment system. I can't see any other option

    Unsuitable or offensive? Report this comment

  • Way more that a fifth more like a third. What about the medicalised social problems stress at work, depressed about life, a letter for back pain. My classic -- attended with sweaty armpits then asked for a letter to say that his mobility car should be upgraded to climate control.

    Unsuitable or offensive? Report this comment

  • I'm surprised the number of patients that support copayment. Signposting hasn't been a success look at NHS Redirect and 111. We cant fulfil demand and wont be able to for a few years yet. I think a ten quid copayment would reduce the workload.

    Unsuitable or offensive? Report this comment

Have your say