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GPs criticised for treating one condition at a time



A patient watchdog has criticised GPs for displaying signs telling patients that they will only deal with one condition at a time at routine consultations.

Aneurin Bevan Community Health Council (ABCHC), which monitors health services in South Wales, said some practices are continuing either to put up signs or to tell patients verbally that they will not deal with more than one condition at a routine appointment, despite previously being warned it was ‘clinically inappropriate and indefensible’.

However, the RCGP has argued that some practices are forced to make such rules to cope with heavy workloads.

The issue was raised at an Aneurin Bevan University Health Board meeting, where the ABCHC’s new annual report was highlighted.

The report states: ’Last year we drew the Health Board’s attention to the bluntly worded signs which we had observed in some GP surgeries indicating that only one medical issue could be dealt with in a routine GP consultation. We considered that such notices could inhibit patients from raising a number of symptoms which may be linked, and could discourage a fuller discussion which might assist an accurate diagnosis.

’The Health Board agreed with this view and the assistant medical director (general practice) communicated with all GP practices in the Gwent area to advise that a blanket policy was clinically inappropriate and indefensible.’

The board said that there has been a ‘reduction in this approach’, but that ’we are still seeing it continue in some areas’

It adds: ’While appreciating the time pressures in GP consulting rooms, we are concerned about the risk to patients if this issue is not fully resolved.’

But RCGP Wales vice-chair Dr Jane Fenton-May said: ’I can see where the CHC is coming from but this is one of the things that GPs have to do to regulate their workload. Some practices have been doing this for a long time.

’If a patient comes in with a shopping list of four or five things then sometimes you just have to tell them that you’ll look at the one that’s most important. Sometimes their problems are linked but sometimes they are not. We are limited to ten minutes per consultation, but the RCGP would like that to be longer.’

Dr David Bailey, Deputy Chair of the WGPC said: ‘GPs should treat holistically, although we understand that sometimes when providing urgent rapid access it may be important to clarify that the time slot is limited.

‘We would not support a blanket rule however, as sometimes a patients different problems are inextricably linked.’

NICE is currently working on guidelines for GPs dealing with multimorbidity, which are due next year.