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June 2019

College announces vision for future of general practice

15-minute minimum consultations, continuity of care through ‘micro-teams’, and an end to isolated working

An end to the standard 10-minute consultation to allow GPs to spend more time with patients with complex needs is core to the RCGP’s vision for the future of general practice.

It states that by 2030 face-to-face GP consultations will be at least 15 minutes, with longer for those patients who need it.

Recent research showed that the UK offers some of the shortest GP consultations amongst economically-advanced nations at 9.2 minutes – with another study finding that the average GP consultation involved discussion of two and a half health problems.

It’s estimated that the number of people with a single chronic condition increased by 4%, and with multiple chronic conditions by 8% per year between 2003/4-2015/16 – and that patients with long-term conditions account for around 50% of all GP appointments.

RCGP chair Professor Helen Stokes-Lampard said: ‘It is abundantly clear that the standard 10-minute appointment is unfit for purpose. But GP workload is soaring, GP numbers are falling, and patients are already waiting too long to secure an appointment. Without more resources and an expanded workforce, longer consultations would simply mean increased waiting times, undermining patients’ ability to access the care that they need.’

Fit for the Future – the College’s vision of what general practice will look like in 2030 – was developed after consultation with more than 3,000 GPs, other health professionals and patients, and research commissioned from The King’s Fund.

The report calls for a ‘step-change’ in the expansion of the practice team. Skill mix has increased but progress has been variable across the UK and from one practice to the next, but by 2030 extended teams should be the norm. ‘Micro-teams’ will be established, comprising clinicians (GPs, advanced nurse practitioners, nurses, healthcare assistants and clinical pharmacists), and admin staff. Patients told the RCGP that ‘wider practice teams improved access to care and reduced waiting times.’ GPs said that expanded teams could help ease workload.

The College’s report states that realising the vision is predicated on six ‘enablers’, including that general practice receives at least 11% of the NHS budget in all four nations of the UK; the full-time equivalent GP workforce expands by thousands, as does the wider practice team workforce, with effective strategies to deliver a supply line of practice nurses and other practitioners; and that GP specialty training is extended to at least four years.

The RCGP will now develop four ‘roadmaps’ outlining what needs to be done to realise its vision and lobby governments and decision-makers to deliver it.