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GPs spend fifth of consultation time on non-health problems

GPs are spending nearly a fifth of their consultation time dealing with non-medical issues at a cost of nearly £400m, according to a new report from charity Citizens Advice.

According to the study, A very general practice, GPs spend 19% of their time dealing with personal relationship problems, housing and unemployment concerns or work-related issues.

It also reveals that three-quarters of GPs say that the proportion of time they spend dealing with non-health issues as part of consultations has increased over the past year.

The report comes after former RCGP chair Professor Clare Gerada said she had referred more people to food banks than A&E in one week.

At the same time, NHS England is encouraging greater integration between social and health care, having given approval to funding ‘social prescribing’ pilot schemes.

GP leaders said that patients’ needs extend beyond ‘bio-medical’ healthcare, but this should not place greater burdens on GPs.

The charity surveyed 1,000 GPs in February this year on the effect of non-health problems on their workload.

The main findings included:

  • 80% report that dealing with non-health queries results in decreased time available to treat other patients’ health issues;
  • 64% report that non-health queries from patients increase the stress of their job;
  • 46% report that non-health issues raised during consultations contribute to increased costs to the practice and to the NHS;
  • 49% say these conversations help them better understand the communities in which they work;
  • 92% report that their patients had raised issues about personal relationship problems with them in the past month.

Citizens Advice has estimated that the basic financial cost to the health service of non-health demand on GPs is at least £395m, representing more than 5% of the NHS England budget for general practice and equivalent to the salaries of 3,750 full-time GPs.

The report said: ‘It is vital to say that this time (non-medical discussions) is not wasted. The GP-patient relationship is stronger for its breadth and should not become too narrow, not least because—as our own research confirms—there are complex links between health and wider social issues.

‘But if even half of the time we identify could be absorbed in other ways this would release 3.4 million hours of GP time and £200m; efficiency gains that could be reinvested in patient healthcare.’

Dr Sam Everington, a GP at the Bromley-by-Bow Centre in east London and chair of NHS Tower Hamlets CCG, who has been leading on the social prescribing referral pilots, said: ‘Patient needs in terms of education, environment, employment or creativity can be equally – or even more – important than bio-medical care in terms of health and wellbeing.

‘But we must recognise that we cannot place a greater burden on GPs. What we have found in Bromley-by-Bow is that having a referral form with a tick box so that we can refer patients to voluntary organisations like Relate for example, if the concern is about relationships, works because a social prescribing team then takes over. We refer patients to a whole raft of organisations such as Shelter and Citizens Advice. It’s all about connections.’