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GPs have ‘chosen’ 10-minute consultations, claims NHS England lead


Dear All, I think i can claim to be the source of the "one appointment, one patient, one problem" concept from when i wrote our first local charter and self help guide, way back in the 1980s. It was adopted by the LMCs of South London and has spread. The flaw in Dr Varnnams hypothesis, and its a big and difficult to avoid one, is that no one knows how long the problem is going to take before its discussed, not me, not him, not the patient, not the receptionist. If we simply spent as long as was needed for each patient as they came in then we'd run fast ahead of schedule, then run late, then fast again because of the very unpredictability of general practice. One patient's chest pain might take 5 mins whereas another's might take 20. You cannot do what he advises if you also want to have any semblance of an appointments system. The only way you can spend as long as it needs as they come through is to have a walk in, first come first served, and "you'll have to wait as long as it takes for me to get to you before your turn" system. Hmm I can see the Head of General Practice Development and other GP gurus liking that. The ten minute one appointment one problem one patient is not ideal but its the best compromise in the circumstances. We tried allowing patients to select 5, 10 or 15 mins for their appointments to see if that would work but hey guess what, patients perceptions of how long their problem would take was a world away from clinical reality. Regards Paul C

Posted date

20 Oct 2017

Posted time