Third of GPs polled say 10 minutes not long enough to make diagnosis

Author: Caroline White

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One in three (35%) GPs admit they might have failed to properly diagnose patients because 10-minute appointment slots are too short, finds a snapshot survey of 200 family doctors on the pressures they are under, carried out for law firm Slater and Gordon.

Misdiagnoses meant sick patients made repeat appointments and needed further medical treatment.

Nearly all of those polled (94%) said short appointment times put patients at risk, with GPs reporting that the minimum “safe” timeframe would be 16 to 20 minutes.

Four in five said they don’t always have the time to properly diagnose patients, with over half (55%) fearing they have missed serious health issues and more than a third (37%) believing they have prescribed the wrong course of treatment.

Half of the respondents (49%) said they are expected to keep appointment times to less than 10 minutes. Others were pressured to reduce this further depending on patient demand.

Nearly all of those polled (94.5%) said they felt stressed or anxious about appointment times.

When asked what changes would improve their working conditions, the most common answer was for them to be given more time to diagnose patients. This was a higher priority for GPs than more resources, flexible working, or better pay.

Many GPs also feared that patients felt unheard or unvalued (51%) and were losing confidence in GP practices (51%).

Of those polled, nearly three-quarters of NHS GPs considered leaving the service for private practice and 45% said they have considered leaving medicine altogether. Most (84%) said short appointments were a factor or the main reason they were considering leaving the public system.

And 43% of respondents said if they knew about the pressures GPs faced before they began studying, they would have chosen a different career.

The GPs polled ranged in length of service from two to more than 30 years, with most serving between five and 15 years.

GP Dr Eleanor Holmes, who is now on sabbatical because her work was taking a toll on her health, commented: “This is not a profession you give up lightly, but no matter what changes I made I couldn’t make it healthy or safe to continue working.

“I want to be a doctor who is fully there for my patients, giving the quality of care I know I am capable of. I believe the current system does not allow for this.”

A “typical” workload was 30 patients each day, over 10 to 12 hours, including two home visits. When “on call” triaging patients she could have contact with 50 or 60 patients, or more, a day.

“This is not safe working,” she said, adding that each appointment creates additional work in the form of referrals, tests, results, reports to write and paperwork to chase. The administration time built into contracts doesn’t begin to cover the work generated, she explained.

“For most GPs, it’s like you’re on a treadmill, you’re treated like expendable machines under unrelenting pressure,” she said.

Professor Helen Stokes-Lampard, chair of the Royal College of GPs, commented: "It has been clear for some time that the standard 10-minute appointment is no longer fit for purpose. As GPs, we want to be able to deliver truly holistic care to our patients after considering all the physical, psychological and social factors potentially impacting on their health.

"But when you consider that very few patients now come to us with just one health-related condition, and that we are increasingly up against the clock in consultations, this is simply not possible and in some cases it could be unsafe.”

She continued: "We have called for 15-minute appointments as a standard, with longer for those patients with complex health needs who need it.”

And she warned: “With GP workload soaring, falling numbers of family doctors, and patients waiting longer for appointments, we need more resources and an expanded workforce to make these longer consultations feasible – otherwise it will only add to pressures and serve to undermine patients' ability to access the care that they need."

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