GP consultations too short for complex cases, says doctors" leader

The length of GP consultations is too short for many people with complex health needs because doctors are “ridiculously overworked”, according to the Royal College of GPs.

The average consultation length of 10 minutes in the UK – thought to be the shortest in the developed world – was “crazy” said the RCGP president, Dr Helen Stokes-Lampard.

While simple health problems could be dealt with in 10 minutes, for people with complex health needs it was inadequate but GPs had to practise “demand management”, she told BBC Radio 4’s Today Programme.

“It is a crazy situation. GPs are ridiculously overworked and there are too few of us – the situation is on the brink.”

Research by the Health Foundation – based on polling of GPs from 11 countries, including Germany, France, Australia and the US – has suggested the amount of time spent by UK GPs with patients is the lowest in the developed world.

The data showed 92% of consultations in the UK are completed in under 15 minutes, compared with 27% in other countries.

Dr Chaand Nagpaul, of the BMA, said: “We spend less than other European countries. We have fewer doctors than other European nations. We have one-third of the hospital beds per head compared to Germany, for example, GPs spend less time per patient than any other European nations. We need to be addressing these issues as a priority.”

Plans to “modernise” the NHS by reducing hospital care and putting more services in the community to save £22bn and make the system more efficient risked undermining care, she said.

The number of GP consultations has already increased by nearly a quarter in the past five years, and while funding for MPs will increase by 14% by 2020, the current infrastructure could not cope, said Stokes-Lampard. “If you haven’t got the infrastructure there you are setting yourself up to fail. It’s a case of putting the cart before the horse.”

Meanwhile, an Ipsos Mori poll for the BBC of 1,033 UK adults found a majority of the public would be open to a tougher approach on people who abuse the GP system.

Seven in 10 said charging people for missed appointments would be acceptable, while 51% said they were against paying to have a guaranteed appointment within 24 hours, although 20% said they would be willing to pay more than £10.

Stokes-Lampard said the issue of charging – which both the Royal College of GPs and the British Medical Association are against – was a “red herring”, as most people who used the GP did not pay for prescriptions and would not have to pay.

GP consultations too short for complex cases, says doctors" leader

GPs offered thousands of pounds to give private consultations via app

GPs attending the UK’s biggest family doctor conference are being urged to accept thousands of pounds to treat private patients.

Medics can earn £50-£60 per hour on top of their NHS salary – or up to £90,000 a year if they work full-time – by offering consultations to patients on their smartphones.

The cash is being offered by the firm Babylon to GPs who want to work “flexibly”. Doctors are told they can work from home or their usual workplace.

The Royal College of GPs (RCGP) has accepted thousands of pounds from Babylon to put recruitment flyers in about 1,500 delegate bags at the RCGP annual conference in Harrogate. Babylon has also paid for its logo to appear on the conference handbook and website.

On Thursday the chair of RCGP, Prof Maureen Baker, said NHS doctors were under intense pressure. She said GPs were “worried about making errors because they are so overwhelmed with work. This is a serious threat to patient safety.”

Babylon is an app-based service that works by offering patients unlimited private GP consultations for £4.99 per month or one-off appointments for £25. Patients can get access to one of 100 doctors for video-call or text-message consultations seven days a week from 8am to 8pm. The firm also offers appointments with specialists from £49.

Katherine Murphy, chief executive of the Patients Association, said GPs were often trying to tackle long waiting lists, but added: “What is disconcerting about this situation is that private firms are allowed to advertise positions at a conference of the RCGP.

“What this means is that NHS doctors are being targeted to give up their role working for our NHS and instead work for private companies, which I think most patients would consider unethical. When the NHS is so desperately short of GPs, how can this be right?”

The RCGP accepts sponsorship money from a wide range of firms for its conference, including the pharmaceutical companies Pfizer and Novartis. In 2014, the most recent year for which figures that are publicly available, bronze sponsors paid the RCGP £11,500 plus VAT.

Dr Mobasher Butt, global medical director of Babylon, said: “As a GP, I see doctors across the country working in public, private and voluntary organisations. At Babylon we work with NHS and private patients. Our GPs are often juggling family and professional commitments, and value the flexibility that we offer.

“Without this flexibility, many would not work additional sessions to their NHS work, which in effect is actually increasing our total national GP capacity. All of our GPs carry out face-to-face practice, mostly in the NHS, and Babylon provides them with a much-welcomed addition to their portfolio of work.”

He added: “We have an excellent relationship with the RCGP, having met members of the RCGP council to discuss our service in detail, which they found impressive. Many of our GPs, including myself, are RCGP members and Babylon is proud to support the college.”

Despite Babylon flyers telling GPs they have the “freedom to work from home or your workplace”, Butt said: “All of our GPs work from home and we do not recommend working from their NHS practice.”

A spokeswoman for the RCGP said: “The RCGP exhibition is a commercial venture that generates income for the college’s charitable work. It showcases latest developments in general practice and all exhibitors go through a rigorous process before they are allowed to take part.

“The decision to allow Babylon to become a bronze sponsor at this year’s conference was taken on the basis that it is an emerging digital healthcare company.”

She added: “They are also working with the NHS in some areas to reduce pressure on GP surgeries by offering virtual consultations. At the moment, general practice in the UK is struggling, and we need to pull out all the stops to recruit as many GPs to the NHS as possible, and retain existing ones. But that is not to say we are in a position to close the doors to opportunities for our members.

“Babylon’s presence at the annual conference is in line with the college’s sponsorship policies. Due to commercial confidentiality we are unable to disclose further details of the sponsorship.”

Last month it emerged that another Uber-style app-based medical service, Doctaly, was being rolled out nationally.

GPs offered thousands of pounds to give private consultations via app

British hospital to turn out to be 1st in Europe to use Skype for consultations

The move – which is component of a range of schemes to ease strain on the hospital, which is coping with massive increases in demand – has been welcomed by well being campaigners.

Ian Syme, coordinator of pressure group North Staffordshire Healthwatch, stated: “So prolonged as the patient is confident utilizing the program it sounds excellent.

“But with vastly developing numbers of silver surfers, it have to not be restricted to the young.”

One particular hospital in North Wales currently utilizes Skype – but only so nurses can check dialysis sufferers at property.

Treating individuals via Skype could avoid up to 180,000 folks a year possessing to get time off perform and travel to clinics.

Officials admit preparing for the move is nevertheless at an early stage, but it has the possible to cut the annual 517,000 outpatient appointments by 35 per cent.

Normal of cases which could be noticed by Skype video conference would be men and women who have had program surgical treatment or other treatment and merely require a medical professional to assessment ultimate scans prior to formally discharging them.

But any individual needing face-to face get in touch with and physical examinations will still be named in to the hospital.

Chief executive Mark Hackett stated: “Some patients get on engineering better that other people.

“But these methods could suit in distinct the underneath-50s who now have to get time off work to get to appointments.

“They would see it as a significantly more wise way forward to avoid producing trips to the hospital.

“We have to look at making an attempt to harness new types of technology. For instance we also need to take away paper data and quit getting plenty of clerks filling in pieces of paper.”

Skype consultations had been last evening welcomed by company leaders and well being campaigners.

Jane Gratton, deputy chief executive of Staffordshire Chambers of Commerce, said: “I feel employers would help this as effectively as their staff.

“For individuals to commit ten minutes speaking to the medical doctor whilst at perform as an alternative of possessing to consider the total day off would support their company’s productivity.

“It is excellent the hospital would like to make best use of the latest technologies.”

The move is component of a selection of schemes to ease strain on the hospital which is coping with big increases in demand.

In A&ampE alone patient numbers have soared by eleven per cent in excess of the winter despite a forecast development of just seven per cent currently being planned for.

The believe in also wants to aid GPs by setting up ‘hot clinics’ where experts can see patients with presently-diagnosed situations – and then send them straight back to their surgical procedure without needing an admission to a ward.

And it is hoping to aiming to shift out a even more 50,000 patients a 12 months through consultants operating clinics in neighborhood settings.

In 2012 the Health-related and Dental Defence Union of Scotland (MDDUS) explained in suggestions to doctors that Skype could decrease the quantity of missed GP appointments.

Healthcare adviser Dr Barry Parker, from the MDDUS, mentioned: “The concept of holding consultations by way of Skype is an intriguing advancement, which might have clear benefits in terms of convenience for sufferers and physicians.

“Seeing your medical professional in a safe and practical way in the comfort of your very own property may possibly appeal to some patients.

“Skype consultations could probably be far better than phone tips calls, in that the patient can see who they are speaking to, aiding communication, and the medical professional can gain an overall impression of the patient’s situation.”

But he added: “The medico-legal pitfalls of Skype consultations are not however fully apparent as it is a latest improvement, but it is anticipated that some of these will be comparable to telephone tips.

“The key problem for physicians will be to recognise when this mode of consultation is not ample to effectively assess the patient and tackle the problem, and to arrange a face-to-encounter consultation instead.”

Currently in North Wales a single hospital – Ysbyty Gwynedd, in Bangor – is pioneering Skype to allow kidney sufferers to use dialysis machines at home.

Rather than commit up to twelve hrs in hospital for treatment each and every week, individuals now have a degree of versatility of when and for how extended they use the machine which helps purify their blood.

The idea of making use of Skype, came from the neighborhood Kidney Patients Association.

Ken Jones, secretary of the Kidney Sufferers Association, explained: “Every week a individuals demands to undergo at least twelve hours of dialysis.

“By utilizing Skype, the patient can stay at home, they do not need to have to get dressed specifically to go out, and can do it in blocks of two hours to fit it in around their life.

“It is 100,000 occasions much better than obtaining to go to hospital.”

British hospital to turn out to be 1st in Europe to use Skype for consultations