Last month, GPs faced some of the biggest blows to practice finance in the last decade: a contract imposition, a tougher QOF, plus the extra costs of locum superannuation and CQC inspection. This month feels like a key moment for GPs to assess workload.
If GPs are to work more efficiently, an analysis of how time is spent would be useful. Ten- or 11-hour days are not uncommon in the profession, but perhaps only five hours a day is spent with patients. The rest is phone calls, visits and administrative work.
Other professions, such as lawyers and accountants, use time recording systems. This is mainly to establish how much clients should be charged, but it also ensures time is not wasted on things that do not need doing. It would be neither appropriate nor practical for GPs to use timesheets regularly. But trial ‘sessional audits’ could be helpful. Since 10-minute appointments are generally the rule, it makes sense to work in 10-minute units.
Running your audit
Build a spreadsheet where the rows down reflect the times of the day. Perhaps start at 8am and end at 8pm. Use the columns to the right to categorise what was done in each 10-minute period. Categories might include face-to-face patient consultations, phone consultations, telephone calls about a specific patient (with other professional), home visits, care home visits, patient admin, QOF, enhanced services, finance, staff, holiday and then the catch-all of ‘other admin’.
At the end of each day calculate how much time has been spent on each category. Make a weekly total and perhaps compare your findings with those of other partners. For some activities, such as looking after care homes, you will see a true picture of how much effort is being put in. This will help you assess whether you are being paid an adequate retainer. You also might find where you spend time on avoidable admin.
I find timesheets a chore, but they make me more businesslike. Where appropriate I can confidently say ‘it’s not worth us doing that’ or ‘the staff can do that’. If GPs want to improve their quality of life and financial stability, they need to respect the value of their time.
Find out how GP Dr Pamela Bowyer got on when she tried Bob’s ‘time audit’, and download her spreadsheet.
Bob Senior is chair of the Association of Independent Specialist Medical Accountants and head of medical services at RSM Tenon