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Ten minute appointments are an 'anachronism', doctors agree

The BMA has voted in favour of longer GP appointment slots as ten minute appointments are an ‘anachronism’ and the current situation is ‘failing the needs of patients’, doctors at the Annual Representative Meeting in Edinburgh agreed.

A motion proposed by GPC negotiator Dr Chaand Nagpaul called for longer consultations and a ‘workforce strategy’ to enable this was unanimously passed by doctors at the meeting.

This brings BMA into line with the RCGP, which has long called for appointment slots to be lengthened, with its honorary secretary calling for 30 minute appointments last year.

The motion said: ‘The progressive movement of complex and chronic care into the community has made the 10 minute GP consultation totally outdated, wholly inadequate and failing the needs of patients, and demands that there should be a deliberate workforce strategy for requisite GP numbers to enable longer consultations with patients.’

Dr Nagpaul called then ten minute consultation an anachronism from ‘a former era in general practice’ and said the brevity of appointments leads to poorer patient care.

He said: ‘We short change our patients with closed questions. We get frustrated when patients bring a shopping list of problems instead of empathising with their multiple misfortunes. This insults our professionalism and undermines the doctor-patient relationship.’

‘Some private companies in America recommend GPs see no more than ten patients a day. Across Europe 20 minute consultations are the norm. We must stop this conveyor belt processing of patients.’

Dr Laura Kelly, from the Medical Student’s Forum, added that when she was a medical students training GPs called her ‘useful’ because medical students are afforded 40 minutes with the patient, and therefore could provide high quality care.

Doctors also condemned the changes to the employers contribution of superannuation for locums from PCOs to practices and agreed to publicly name deaneries failing to adhere to guidance which says GP training should include a minimum of 18 months in general practice.

 

Motions in full

 

524.  Motion by Edgware and Hendon Division

The BMA has voted in favour of longer GP appointment slots as ten minute appointments are an ‘anachronism’ and the current situation is ‘failing the needs of patients’, doctors at the Annual Representatives Meeting in Edinburgh agreed.

 

523.  Motion by the Agenda Committee

 Motion to be proposed by the Sheffield division:  That this Meeting is concerned that the quality of GP training is being compromised and calls on the BMA to lobby COGPED to:

 i.ensure adherence to the current guidelines for GP training which include a minimum of 18 months training in general practice;

ii.ensure, when four year GP training is implemented, a minimum of twenty four months training in general practice;

iii.ensure hospital training posts are of an appropriate length for GP training;

iv.publicly name the deaneries (or equivalent bodies) that are failing to adhere to their guidance.

 

522.  Motion by Yorkshire Regional Council

That this Meeting:

i.condemns the government’s move to transfer the responsibility for paying employers superannuation for locums from PCOs to practices;

ii.insists that all practices should treat locums fairly and pay employers superannuation contributions in addition to the locum fee whenever the locum is still in the pension scheme.

Readers' comments (6)

  • I'm sure majority of my patients would agree they'd rather be able to see a doctor for 10min, rather than have to wait for 3 times longer to see a doctor for 30 min!

    And of course DNA will waste 3 times as much resources as well

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  • Problem is, with 30 minute appointments too many people would expect a cure! I would suggest targeting a selection of appointment times to different patients.We do this to some extent already anyway.

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  • What's the point of encouraging a 10 minute appointment if there is no money or doctors to match the extra time taken? All that will happen is that anything less than 15 mins will become unacceptable to the powers that be but there will be no extra income and we will all end up working even harder. It is happening anyway - most of our practice has a break every 4-5 patients but still see the same number of patients. We are just working longer hours and it will be longer still if we start consulting at 15 mins. Nice idea - but the money will not follow.

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  • I have trialled 15 minutes appointments but seeing patients for 10-12 minutes, and writing up/referring after. Much more relaxed, patients seen on time and they seem relaxed, and I feel less over-worked. It does shrink my admin time, but in between quick cases I can catch up on that. 20minutes may be too long unless patients have lists, but may be offering them a choice of 10 or 20 minutes, depending on 1-3 complaints, seems a good idea (and one to trial!).

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  • I have an easy solution for this, how about the government actually starts paying us per appointment we actually do. At current going rate I believe we would get paid at least £50 per 20 minute consultation, how about £20 per telephone consultation, what about rates for visits at £100 per visit, given that each take at least 30minutes plus paperwork and travel. I calculate we would earn at least £2000 per doctor for an average working day, probably more. That translates to about £350,000 per doctor per year, if they work a 4 day week with 7 weeks holiday.

    Or how about another way of calculating it, given that my practice has 8000 patients and our average consultation rate is 7 consultations per year per patient, lets do a flat rate of £50 per consultation (bargain!!) for all of our patients.

    Guess what..... that will cost the tax payer £2,800,000 for my practice alone!! More than happy to move to 20 minute consultations at that sort of pay.....

    How about recognising we are actually getting paid pennies for a quality service?

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  • Anonymous 1003, I agree. Our current pay per consultation [ take home ] varies between £2.50 TO £ 4.00. £60.00 PROFIT per year deduct NIC?TAX = £ 30.00 divide by 7 Consultations - only 60 % of workload = £ 2.50
    If we are lazy, golf playing GPs, fine, just pay us per consultation, it should cost so little as we will playing golf. Now, I wonder why they don't.

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