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Increased consultations in primary care burdening nurses and GPs

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Increasing consultations in primary care In under decade, primary care has dealt with a significant increase in consultations

General practice has reached 'saturation point' say researchers following the most comprehensive analysis of primary care to date.

Researchers from the National Institute for Health Research School for Primary Care Research, found that general practice consultations have increased by 16% since 2007 and patients are having longer consultations.

Practice nurse consulations have increased by 0.9% over this period. The number of face-to-face consultations with nurses increased by 3% and were 6% longer by 2014 increasing to 9.72 minutes. Overall, there was a 10% reduction in telephone consultations for practice nurses.

Lead author Professor Richard Hobbs, Head of Oxford University’s Nuffield Department of Primary Care Health Sciences, Director of the NIHR School for Primary Research and a part time GP, said that these results could enable CCGs to estimate the numbers of GPs and nurses needed to deliver direct clinical care at the current levels of demand, based on the mix of people in the local area.

'Most English practices offer patients 10 minute appointment slots, based on the expectation that some consultations will be shorter or patients won’t show up, so longer consultations can be accommodated within the booked clinic. Since the average face-to-face consultation is now approaching that 10 minute threshold, there is no longer any slack - GPs and nurses are now consulting throughout the booked clinic without a break and demand for those clinic slots is rising,' he added.

The highest consultation rates were in children and the elderly and in women compared with men of all ages.

Co-author Professor Chris Salisbury, a GP and head of the University of Bristol's Centre for Academic Primary Care, said: 'Because consultations are both happening more often and taking longer, the combined effect is that overall workload of doctors and nurses in general practice has increased by 16% over the seven years, while time spent by GPs with patients has increased by 18%.'

The data was analysed from 100 million consultations with GPs and practice nurses across England from 398 GP practices between 2007 and 2014. The research was published online in The Lancet.

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