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Offering phone consultations as standard ‘could increase GP workload’

The telephone-first approach is not a cure-all solution to reducing GP workload and freeing up appointments, a study has found.

Asking patients to speak to a GP on the phone decreased the number of face-to-face consultations but increased the overall number of consultations by close to a third.

Researchers analysed data from 150 practices that adopted a telephone-first approach, where a GP speaks to a patient on the phone before offering them an appointment.

After the system was introduced, there was a 38% decrease in the number of face-to-face consultations but a 28% average increase in the total number of consultations. Around half of patients were asked to come in for a face-to-face appointment.

According to patient surveys, there was a large increase in patient satisfaction with the time taken to speak to a GP, corresponding to an average 20-point increase on a 0-100 point scale for satisfaction.

The authors of the study, published in the BMJ, also noted an increase in the time spent consulting, although this figure had a large degree of uncertainty.

They pointed out that the averages masked large variations between practices, with some experiencing double the amount of consultations and some having their overall number of consultations reduced by over two-thirds.

The paper said: ‘For clinicians, this study provides clear evidence that a considerable part of patient workload can be dealt with through phone consultations.

‘This might increase the practice’s control over day-to-day workload but does not necessarily decrease the need for GP time and could increase it.’

RCGP chair Professor Helen Stokes-Lampard said: ‘It is up to individual practices to decide what appointment booking or triage systems they implement to manage their workload most effectively for that particular patient, but we want to reassure patients that technology will not be replacing the work of GPs.

‘GPs are highly trained to take into account the physical, psychological and social factors potentially affecting a patient’s health and often these are non-verbal, so phone conversations will never replace face-to-face appointments completely.’

BMJ 2017; available online 27th September