Editorial Comment

Why are there No GP Appointments?

If BMA figures are to be believed the average GP working nine sessions a week will see an around 23 patients per session. If that is so the average session would take between three and four hours leaving little or no time for other duties.

If the average list size of an individual GP was around 1,800 patients and the average number of times a patient would see a GP in a year was five then in a typical session a doctor would see patients taking just over three hours. The Quality Outcomes Framework originally encouraged GPs to spend at least 10 minutes with each patient.

Prior to 2004 I recall that sessions lasted around two and a half hours but after 2004 sessions started to last up to three and a half hours. In my mind this was due to the shift to computer based records and the need to record everything that moved by using codes and scoring points under QOF. Added to that GPs were being asked often reluctantly to use the Choose and Book referral system. QOF has changed every year and there is now 10 years later a concentration on the more unusual Enhanced Services to such an extent that it makes your mind boggle. At least one GP per practice is expected to take  part in Clinical Commissioning Group activities and the number of sessions needing to be taken out of the working week is increasing by other duties and outside commitments.

Is it any wonder that it is so difficult to get an appointment with the doctor of choice. Some Practices manage it and I believe they only do this by having sufficient doctors to deal with the level of demand. A recent GP Manpower Survey carried out by this web site suggested that on average practices were short of at least one half time GP. The recommendations of the survey suggested that Practices needed to be very careful about allowing any member of the practice to reduce their sessions. It also suggested that part time GPs should work with other in a job share basis so that when absences occur there is always cover. In fact, GPs are expected to provide cover for Extended Hours when they are absent………

Time will only tell whether general practice in the UK can survive without more careful management of GP Manpower and not the ‘free for all’ permitted today.

Robert Campbell – September 2015 (Revised)


Robert Campbell

By Robert Campbell<br><img src="" alt="Robert Campbell" class="avatar" width='50' height='50'/>

Started work writing medical cards in 1966 at Staffordshire Executive Council. Have worked at Inner London Executive Council, Hertfordshire Executive Council, Lambeth Southwark and Lewisham FPC, Birmingham FPC, Dudley FPC and Wakefield FPC and Family Health Services Authority. I was seconded to the NHS Appeals Unit and have worked as a full time GP practice manager since 1992 until 2010. I was also an AMSPAR trainer at Park Lane College, Leeds. Now I work as a freelance author.