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A faulty production line

Ten-minute consultations 'must go', says NHS England director

The age of 10-minute GP appointments ‘has got to go’, as the limit is ‘unsafe’, a senior director of NHS England has said.

Speaking at the main debate rounding up the Pulse Live conference in London today, Dr Mike Bewick, NHS England’s deputy medical director, said this must ‘undoubtedly’ happen.

However GPC chair Dr Chaand Nagpaul said GPs could not lengthen consulations without reducing patient access to appointments.

Responding to a question from the floor, Dr Bewick said: ‘I think the age of the ten-minute appointment has got to go, undoubtedly. As a commissioner, I think it is unsafe as well.’

‘I think you have got to manage what comes in through the door as well, at least make an attempt to put something in that stops people getting through in cases where self care would have been more appropriate.’

‘I think that requires training, as an issue for practices, not necessarily for individual GPs, and probably a training issue for larger providers of general practice.’

The BMA voted in favour of abolishing the 10-minute appointment at its annual representative meeting in Edinburgh last year, declaring it a thing of the past, and GPC chair Dr Nagpaul, who was also on the Pulse Live panel, said: ‘Ten minutes is a total insult to so many of our patients… I would like to offer 15-20 minute appointments but if I do that I would have to tell them that they have to wait two weeks to see me.’

Questions from the floor also focused on reducing expectations and demand on GPs from patients, to which Dr Nagpaul responded that he would like to see schools educating children what to expect from GPs, as well as how to manage a cold.

He said:‘Demand management and self-care is very important – educating patients and the public about how to use a limited resource effectively and responsibly. I think children in school should be educated about the role of GPs, the role of the pharmacists, and actually how they can manage colds and sore throats themselves.’

Readers' comments (58)

  • Vinci Ho

    It is good for Kissinger to play the good guy and say what should have been said long ago.
    But where is the commitment and actual investment to make this happen ?

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  • The whole debate is meaningless, some patients need 30 mins, but others only need 2-3. We need to run flexible systems, that is the challenge

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  • Chris Kenyon

    Longer consultations will mean appointments per GP so we will need more GP's whatever (as we will need to also be on the phone keeping out things that don't need to be seen). We are constantly being told about a looming manpower crisis - large numbers of GP's retiring in the next few years but trainee places not increasing. It doesn't add up, it can't happen.

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  • Dr Mustapha Tahir

    One cap never fits all! The NHS bosses never think so!!

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  • The RCGP has been calling for longer appointments for years. Good to hear NHS England is on message. Wait a minute, though how to fit the same number of patients into the working day to maintain access
    Now where did Hermione put her "time turner"?

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  • Drachula

    Yes, I need a time turner too!
    More investment for more GPs and prescribing nurses - ours is excellent and we hate it when she is away on hols!

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  • Bob Hodges

    Give me just a little more time, and our love will surely grow!

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  • 15 minutes should be the standard we all aspire to now. We need to be brave enought to get on and just do it - it actually works really well.
    If you are still getting 2 -3 minute appointments your systems are not working - a GP should not be seeing those in 21st century - they should be elswhere or not in the system at all.

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  • I disagree, lots of practice do telephone consults lasting less then 5 mins , you can't really solve stuff in 1 appt anyway.
    Follow up appt can be done in less then 5 mins , eg blood test normal, prescrbing contracpetion etc etc
    Bp review,
    Obviously for complex problem you need longer and flexibility is key which frankly is far more important and works much better.

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  • Everybody blames the patient - absolutely wrong!!!
    It us - our tools and our expectations - professional and paymaster.
    The classical patient with single problem, GP diagnosis and advice and treatment fit nicely into 7.5 10 or 12 minutes - which ever suites you best.
    It's the agenda from behind- QoF, guidelines, check lists etc... that add to the length. The new generation of computer software is also a major consumer of valualble time - both looking for information and the burden of record keeping - both adding 3 -4 minutes before and after consultations at worst.
    Mike Bewick is absolutley correct - in this complex multiple co-morbidity world 10 minutes is no longer safe.

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