GP phone consultations increase workload by 33%

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75% of patients require a second consultation

A new study has shown that introducing GP phone consultations instead of face to face appointments does not ease pressures in hectic surgeries – in fact, it increases the workload.

Researchers at the University of Exeter Medical School analysed 42 practices, where a GP or nurse phoned back on average 20 patients who needed an appointment on the day instead of them coming in to the surgery. With the British Medical Association (BMA) believing GP’s were “under real pressure” from soaring patient demand, the use of telephone consultations was hoped to relieve some of the pressure.

Results instead found that phone consultations increased the number of patients being dealt with, by 33% when a doctor phoned back or by 48% when a nurse made the call. The research also discovered that phone consultations led to more patients needing a second appointment. If the initial meeting was in person, only 50% require a second appointment, however if the first discussion was over the phone, 75% of GP calls and 88% of nurse calls needed a second consultation.

How to ease pressures?

Lead researcher Prof John Campbell told the BBC that the phone calls were still a valuable and good service, particularly for those who couldn’t get time off work, however they could also harm the relationship with patients who prefer to come into the surgery. “This is not the silver bullet to dealing with workload. Introducing it in some settings will be very useful, but it needs to be introduced with caution,” he said.

Dr Richard Vautrey, the deputy chair of the BMA’s GP committee, said “A key problem is that general practice as a whole is under real pressure from soaring patient demand and falling funding, which often means that practices don’t have enough GP’s or nurses to operate these services in addition to managing their current workload.” Dr Vautrey also pointed out that phone services increased demand from people who would not have come to an appointment, or would have managed their condition at home. He said it was important to get the balance right and ensure face to face consultations were not completely replaced, as “there are many conditions that can only be safely treated by direct examination in the GP practice”.

A spokesperson for the Department of Health said “Most patients can get appointments and we’re offering 7.5 million more people email, Skype and evening and weekend slots. GP’s know what works best for their patients so can tailor their services as they see fit and based on what patients need.”