Practice dilemma: Introducing 15-minute appointments
One partner has suggested we begin to extend our routine appointments from 10 to 15 minutes. How do we reach an agreement that protects patients’ interests without giving ourselves an unmanageable workload?
If one partner has recommended an extension of appointment slots from 10 to 15 minutes it is important to understand the reasons why this is being suggested. You might ask:
- Does the partner in question feel that, without such an increase, service to patients is inadequate?
- Is this due to the abilities of the partner in question, who finds it difficult to deliver the services in a reasonable time?
It is important that the views of all partners are sought and a realistic assessment made of the input on the number of patients seen and hours worked. An increase from 10 to 15 minutes will result in only four consultations per hour rather than six, which will lead to a greater delay in patients getting appointments and consequently could reduce patient satisfaction.
Your PCT is likely to require you to provide a minimum number of patient appointments each day dependent upon your list size, so this should also be checked. On this basis, the extension of length of appointments will have to be met either by the current partners agreeing to work longer hours to accommodate this or by agreeing to pay other doctors to do so, with the resultant hit on profits.
Could the time pressure problem faced by the individual be better accommodated by another means? For example:
- If he or she sees a high number of patients who require more time, should they be encouraged to book double appointments?
- Alternatively, could the receptionists book out a few ‘blank’ slots during the course of a clinic to allow time to catch up?
- If the problem is an admin one, can additional (and less expensive) labour be introduced to undertake routine tasks which the individual GP is attempting to undertake him or herself within the allotted appointment time?
With the ever-increasing competing pressures on a GP’s time, partners need to work together in order to ensure they provide the range of services required pursuant to their Contract. With this in mind in is worth considering the requirements of your partnership agreement in terms of the expectations of commitment from each of the GPs.
Where partners reach agreement to vary their obligations as set out under this document, a variation to the partnership arrangements is relatively straightforward. If specific obligations are unspecified, it is likely that the overall work will need to be spread between the partners. This may require a further variation of the roles each partner performs, with some dealing with longer sessions to accommodate longer appointment times (if necessary) and others taking on other obligations.
Above all, it is essential to ensure that obligations are clear – and that the partnership agreement permits sufficient flexibility to enable further change as the need arises in order to reflect changing NHS requirements.
Edwina Farrell is an Associate at Hempsons law firm