10-minute GP visits 'can damage health'

Published on Saturday 7 March 2009 19:44

PATIENTS should get a 50% increase in appointment times with family doctors to reduce the danger of potentially serious health problems being missed, Scotland's most senior GP said last night.

Dr Ken Lawton, chairman of the Scottish Council of the Royal College of General Practitioners, said the amount of time allotted for each visit should be increased from the current standard of 10 minutes to a quarter of an hour.

Practice nurses now carry out many routine tasks once performed by doctors and Lawton warned GPs had been left with more complex cases that can take longer than 10 minutes to examine.

He told Scotland on Sunday: "There's always a fear that if we don't have long enough to fully explore the patient's needs within the consultation we will miss something or the patient may feel hurried.

"Patients will bring along something apparently minor and just be getting up the confidence to bring up the embarrassing problem such as bleeding from the back passage, which is the red flag for us to start thinking about bowel cancer."

He said that in situations where doctors are running late they felt "under pressure", particularly when other patients were waiting outside.

"The situations that do take longer are the complex diseases with two or three illnesses together, or if someone has a psychological problem.

"If someone breaks down in tears or are very obviously depressed, you cannot cut them short or fully explore that with the patient.

"The issue for us is we don't know what's coming in the door next and it can be anything. I think realistically 15 minutes would be an appropriate target. It's something we would like to work towards."

Lawton's colleagues say that while they back the idea they cannot hire extra staff to take on the workload because of Scottish Government funding uncertainties.

Dr Dean Marshall, head of the British Medical Association's Scottish GP committee, said: "You can go to your GP and ask anything. People come in to me with their diabetes, a rash, worried about someone in their family and they have also got housing problems; we are the only people in the NHS that do that.

"A 10-minute appointment is not long enough to assess the complex medical problems we get – 15 minutes would be ideal to allow a proper assessment.

"To do that you would have to take on more doctors, but there's no way of bringing them in at the moment. Because of the way we are funded, there's no way of practices expanding.

"GP income has dropped significantly in the past three years and the Government keep cutting back our funding."

The call comes amid a new debate about the future of services for patients. The BMA has launched a public consultation on the future of general practice.

Margaret Watt, chairwoman of the Scotland Patients' Association, said: "Thank goodness someone is listening to patients. If GPs have more time for patients there may be a few whose conditions are not misdiagnosed because of insufficient time."

Scottish Conservative health spokeswoman Mary Scanlon said: "This means doctors would see fewer patients in a day but there's no doubt that for many patients it would lead to much more accurate assessments."

A Scottish Government spokesman said they would consider the calls alongside other suggestions from the BMA's consultation.

He added: "This Government has clearly set the interests of Scotland's patients as our primary focus when considering changes to general practice."

Why 10-minute appointments?

It is up to GPs to decide how long to offer for appointments, but they are required to meet a 48-hour waiting time target.

This has meant that 10 minutes has become the standard appointment time to ensure that everyone is seen. In the past, GP appointment times have varied from five minutes to seven, when doctors were more involved in carrying out fast, routine checks, such as blood pressure, blood tests, and diagnosis of coughs and colds, now increasingly dealt with by practice nurses.