Study raises doubt over effectiveness of lengthier GP appointments

A study published in the BJGP and funded by the Department of Health has concluded that offering longer GP appointments might not significantly improve a patient’s experience.

The research found that longer appointments did not increase patients’ ratings related to either trust or confidence in the doctor; communication; or overall satisfaction.

The news comes as health leaders such as the Royal College of General Practitioners (RCGP) and the General Practitioners Committee (GPC) are campaigning for longer consultations.

The study involved measuring consultation time by video recording 440 face-to-face consultations in 13 general practices from 45 GPs in England. Patients who consented to being filmed then filled in a questionnaire afterwards to measure their experience, on a scale from 0-100.

The findings indicated that patients on average rated the 'communication' aspect a statistically insignificant 0.02 higher per extra minute of consultation; the 'trust and confidence' aspect a statistically insignificant 0.07 higher per extra minute; while the 'overall satisfaction' score fell by a statistically insignificant 0.14 per added minute.

The consultation length in the study ranged from two minutes and 15 seconds to over 30 minutes.

The report said: “There was no association between consultation length and patient experience of communication, trust and confidence in the doctor, or overall satisfaction.”

It added that 'some consultations may be appropriately short, with both doctor’s and patient’s agenda effectively addressed, for example, where the doctor is dealing with a simple administrative issue or following up a problem with a patient whom they know well'.

Professor Maureen Baker, RCGP chair, said: “Sometimes a patient can visit their GP and be in and out of the consultation room in a few minutes. That’s great, and for the patients in question, satisfactory. But for many patients this is not the case...

“GPs are also being asked to do more, particularly in terms of prevention of illness and giving advice, and short consultations do not lend themselves to this. GPs want to deliver the best possible care to our patients, and for patients with single, straightforward conditions, this might be possible in 10 minutes.'

Dr Richard Vautrey, GPC deputy chair, said: “This is a useful study that will contribute to the debate in this area but it's also clear from major BMA surveys that many GPs are under huge pressure within the constraints of a limited length of time of a typical 10 minutes consultation and believe that this does undermine the quality of care they are able to deliver.”