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Of course we need to offer 15-minute slots - but how, exactly?

I audited all my consultations in some detail for a month, in order to analyse how I was spending my time ('GPs struggling to make eye contact with patients').

I realised running to time was impossible if I was to fulfil all the tasks I needed to do - not only dealing with the patients in front of me, but responding to nurse consultations, authorising hospital admissions and taking calls from consultants or staff.

Surgeries did not always start on time because I would be finishing off house calls, waiting for another healthcare professional to leave my room or coping with computer crashes and jammed printers. I estimated I would need 15 minutes per consultation, as opposed to the current 10 minutes, but that this would mean I would not be able to have lunch or take a half-day.

The solution would appear to be simply more time for doctors to consult in, but this cannot be done unless we have more doctors.

We already have a good number of nurses running chronic disease clinics and acute triage. The problem is that they also generate work for GPs even if they make our practice much more efficient.

From Dr Katharine Morrison, Ballochmyle, East Ayrshire

I have moved to 15-minute consultations because of the increasing stress of continually running late.

Patients kept getting agitated about being kept waiting and reception staff were getting irritated at being left to manage them.

I now usually run to time, but at worst only 30 minutes late. Sometimes, if there are DNAs, I can have time to fill, but I can usually find something to do.

The tasks that need completing during a consultation include collecting data for the QOF and enhanced services, completing all elements of a medication review and making referrals through Choose and Book, which takes five minutes.

Generally speaking most of these things benefit patients. They get more consistent clinical care, as we are following more protocols, more information about how to manage their own health, and usually get a more efficient service.

But I find that if I don't have 15 minutes, I am trying to push my agenda at the detriment of the patient's. If we deliver on a patient's own agenda as the priority, we risk missing out on QOF points, or cutting corners and offering substandard care.

From Dr Emma Rowley-Conwy, Streatham, south London

Waiting patients

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