‘Unnecessary’ workload costs practices £410 per GP daily, RCGP warns

‘Unnecessary’ tasks are costing general practice more than £400 per GP per day, a study commissioned by the RCGP has revealed.

Tasks such as navigating fragmented referral pathways, inappropriate triage, and test result follow-up represented the ‘highest time burden and cost of lost time’, according to the researchers.

But beyond the financial implications, the study warned that this workload has ‘a profound impact’ on GP morale, wellbeing, and job satisfaction.

The research sought to capture aspects of general practice that are ‘typically overlooked’ in national appointments data, including ‘hidden labour’ that takes place before, after, and beyond formal consultations – as well as the ‘cognitive and emotional burden’ of tasks that participants viewed as ‘avoidable, misdirected, or inappropriate’.

The college commissioned the study to address the research gap around unnecessary GP workload, and to help lay the groundwork for an ‘evidence-informed’ approach to tackling the issue.

The research identified unnecessary tasks within general practice in England through a mixed-methods approach, combining a narrative literature review, qualitative semi-structured interviews with GPs and a ‘time and motion’ study – which recorded the mean time spent per GP on each task categorised as unnecessary, alongside the corresponding estimated cost per GP per day.

The term ‘unnecessary’ refers to administrative, clinical, or regulatory duties that do not require GP-level expertise or are seen to ‘add little direct clinical value’. But the study pointed out that GPs frequently described these tasks as ‘pointless paper exercises’ or ‘behind-the-scenes work’ yet also acknowledged that some inefficient tasks ‘hold relational or ethical significance’.

Across all categories (see box), the total estimated cost of tasks in the study was £410.53 per GP per workday.

In terms of specific examples provided to the researchers, housing letters were described as ‘complex, frequent, and emotionally fraught’, especially when patients were vulnerable or at risk.

GPs spoke of spending ‘45 minutes to an hour’ on a single housing letter, ‘mining records and composing persuasive narratives’, even when it was ‘not contractually our responsibility to provide letters to housing’.

The study added: ‘Despite this, the moral imperative to support patients remained strong: “I’m prepared to do it… because I think if I can actually help them get off the street, that’s a worthwhile thing to do.”’

And fit notes were described as ‘administratively heavy’ and ‘often misaligned with clinical judgement’. GPs observed that many requests stemmed from HR departments rather than clinical need.

The researchers found that although ‘each note may only take 5–10 minutes’, the ‘cumulative volume’ resulted in ‘significant time drain’.

Other examples of low-clinical-value but time-intensive tasks included PIP and DVLA forms and reports.

And prescription-related tasks, especially those initiated by secondary care or other providers,
were described as ‘duplicative and risk-laden’, with GPs reporting spending evenings and weekends verifying instructions, checking for interactions, and chasing missing details.

The study also found that referral pathways were described as ‘highly inefficient’ due to clunky systems, form inconsistencies and frequent rejections.

The study added: ‘The estimated average daily cost of such “unnecessary” workload amounted to £410.53 per GP. These findings offer evidence for system-level reform, particularly around reducing duplication, clarifying inter-agency roles, and simplifying referral and prescribing responsibilities.’

But the researchers also added that the ‘true cost’ may be greater than what the financial figures alone suggest, as the ‘emotional and professional toll’ of these tasks was ‘evident’ throughout the interviews conducted as part of the study.

They added: ‘Many GPs spoke of working long hours to complete administrative tasks outside clinical time, often during evenings or on supposed rest days.

‘The inability to “switch off,” the frustration of completing tasks for which they felt unqualified or undervalued, and the knowledge that such work was pulling them away from patient care, all contributed to what several described as moral injury.’

GPs told the researchers of ‘emotional fatigue’, erosion of clinical time, and the ‘demoralising effect’ of routinely completing tasks they believe should lie elsewhere.

‘The perceived impossibility of pushing back, or the futility of doing so, leads many to simply absorb the workload, often outside of contracted hours, contributing to burnout and workforce attrition,’ the researchers said.

The study concluded that concept of ‘unnecessary tasks’ is useful for highlighting inefficiencies and redirecting attention to core clinical work, but said that it must be ‘handled with caution’ as many tasks currently burdening GPs are the result of ‘systemic dysfunction’ rather than individual inefficiency.

‘Tackling them will require investment, redesign, and cultural change, not only to reduce avoidable burden, but to preserve the values of general practice,’ the study said.

RCGP chair Professor Victoria Tzortziou Brown said that the study found that a ‘significant’ proportion of GP time is taken up by tasks that add ‘little or no value to patient care’.

She said: ‘Identifying and reducing this hidden workload is essential if GPs are to focus on what matters most: caring for their patients.

‘However, this must go hand in hand with action to increase GP numbers and sustained investment to ensure general practice is viable and sustainable for the future.’

A Department of Health and Social Care spokesperson said: ‘We inherited a system where GPs were bogged down by paperwork, but this Government is fixing the front door of the NHS by slashing red tape to ensure they can spend more time treating patients.

‘We’re working with GPs to improve NHS productivity and bring back the family doctor, so patients get seen on time and taxpayers get maximum value for money. We’ve already reduced bureaucracy by halving the number of outdated performance targets that GPs must meet so they can do what they do best – caring for people.’

In the 10-year plan for health, the Government renewed its pledge to cut NHS bureaucracy, including for GPs, delivering the recommendations of the Red Tape challenge, as well as focusing on outcomes rather than bureaucratic processes.

And in the next two years, the Government promised to support providers to roll out technology to cut ‘unnecessary administrative and clerical work’, including a wider use of artificial intelligence (AI).