Bytheway... Patients want time with a GP, not an app

THERE is no relief on the horizon from the unfurling crisis in general practice. Our minds were focused on this yet again last week, with the announcement that GP services in one area are being provided via smartphones or tablet devices.

But giving medical consultations that are not face-to-face is to give second-class care — all quality doctors agree on that.

A new study looking at GP consultation times in 67 countries reveals the extent of the parlous state of primary care in the NHS, with the UK’s average consultations among the shortest in Europe and ranked 29th in the list.

Even Egypt recommends giving 30 minutes per patient, yet here, the average GP appointment is a dismal nine minutes and 22 seconds. Most GPs will say shorter consultation times compromise quality of care.

Another significant finding was an association between physician burnout and the stress imposed by short consultations. That’s compounded by other issues we’re already aware of: exhaustion, disillusionment, a lack of funding. I could go on.

But let me highlight one key factor: the number of patients GPs look after. When I visited Cuba in March, I learnt that each doctor treats between 120 and 150 families. With such a small list, the doctor has a detailed knowledge of every patient. In the UK GPs treat patients from a list of 2,500 to 3,000 people, up to 40 patients a day.

Is it a surprise to hear this impoverished country boasts a life expectancy close to that in the UK? The reasons why are not hard to find: they start with having the time needed to give support, advice and continuity of care.

We need a major rethink about how to fund primary care and the way it is delivered. Fancy soundbites about the innovation of smartphone consultations will not cut it: doctors need more manpower and more time.