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GPs in the United Kingdom are seeing fewer patients than they were 14 years ago but spending more time with each patient, a survey has shown.
The survey also shows that full time GP partners are working an average of 44.4 hours a week, similar to in 1992-3. The BMA has said that the longer consultations reflect the increasing complexity of general practice and the fact that GPs are treating more patients who used to be cared for in hospital.
Laurence Buckman, chairman of the BMA's GPs' committee, said, “What has changed is the way we work. Intensity has rocketed. Patient care that used to routinely take place in a hospital setting—such as diabetic care, cardiac care, and asthma care, is now routinely done in general practice. It used to be commonplace to be called to a child with uncontrolled asthma or a patient with heart failure and send them to hospital. Now it's a rare occurrence.”
The survey was carried out by the NHS Information Centre on behalf of the four UK health departments, NHS Employers, and the BMA GPs' committee. Out of 4000 practices in the UK that were invited to take part, 329 returned diaries for their workload for one week in September or December 2006, recording the amount of time they spent on predefined activities.
The report says that it is difficult to make fair comparisons with the previous GP workload survey carried out in 1992-3 because so much has changed in the way that GPs work and are contracted. Different methods were also used for the surveys. In particular, the previous report included out of hours consultations, which are not covered in the 2006-7 survey because most GPs have opted out of providing the service under the contract that was introduced in April 2004.
The data show little difference between the average weekly hours GPs worked in 1992-3 and in 2006-7, when time spent working out of hours is excluded from the analysis. In 1992-3 full time and part time GPs worked an average of 35.9 hours a week in normal hours compared with 36.3 hours for GP partners in 2006-7.
Some comparisons are easier to make, however. In 2006-7 the average number of patients a week seen by GP partners was 88, 28% less than the 122 patients a week seen by GP principals in 1992-3. And the average length of consultations has increased, from 8.4 to 11.7 minutes.
A second study published this week shows that on average patients in England attended their general practice 5.3 times a year in 2006, compared with 3.9 times in 1995. The study, Trends in Consultation Rates in General Practice, used computer records to examine how consultations in general practice have changed in the past 11 years.
Overall the number of consultations in general practices in England rose from 220.1 million in 1995 to 289.8 million in 2006. The ratio of consultations with nurses and GPs has changed during this time, with nurses now carrying out one in three consultations compared with one in five in 1995.
Although most people continue to see their GP at the surgery, the survey also shows that GPs are carrying out three times more consultations by telephone than they were 11 years ago, with these consultations increasing from 3% of all consultations in 1995 to 9% in 2006.
Tim Straughan, acting chief executive of the Information Centre, said, “As patient consultations increase, it [the second report] shows practices are adapting the way they deliver care, with nurses carrying out an increasing proportion of care. GPs, however, while seeing a smaller proportion of patients, are now able to spend longer with those they do see.”