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Just 10% of patients take up 40% of GP appointments, study finds

Just 10% of patients take up 40% of GP appointments and visit their practice 60 TIMES a year, major study finds

  • Some 40% of appointments are taken up by just one in ten patients, study says
  • ‘Regular’ attenders visit GP surgeries to see doctors around 60 times a year
  • They are mainly elderly patients with chronic conditions such as diabetes 

Family doctors are being overwhelmed by a small group of ‘frequent attenders’ who have five times more appointments than other patients, research shows.

A study of 1.7 billion GP consultations over the past two decades UK found 40 per cent of all appointments are taken up by just ten per cent of patients.

These ‘regulars’ attend their GP surgery around 60 times a year, five times more than other patients.

They are mainly elderly patients, in particular women, with chronic diseases such as diabetes, dementia or heart failure that require regular monitoring.

The University of Manchester research — which looked at 12.3million patients over 20 years — found the number of appointments for ‘frequent attenders’ has doubled in the past 20 years.

This has contributed to ‘unmanageable’ workloads for family doctors and led to a reduction in face-to-face appointments for other patients, even before the pandemic.

The above graph shows the proportion of GP appointments that were held with a doctor since February 2019. It reveals that the proportion is rising but is still far off pre-Covid levels 

The major study looked at more than 1.7 billion GP consultations over the past two decades

Author Professor Evan Kontopantelis said: ‘This is the first study to show that frequent attenders, the top 10 per cent of consulters, have largely and progressively contributed to increased workload in general practices across the UK over the last 20 years.

‘A relatively small number of patients are accounting for a large proportion of GP workload including face-to-face consultations.

A senior GP last night backed calls to slash the quarantine period for coronavirus cases from ten to seven days.

With Health Secretary Sajid Javid said to be looking hard at relaxing the rules, Dr Rosemary Leonard claimed it was now time to look at whether the lengthy quarantine period was ‘really necessary’.

She said she was very concerned about the ‘huge staff shortages’ now facing the health service because so many were being forced to isolate.

Most of those catching the Omicron variant only have mild illness and recover quickly, she added.

Ministers have asked their scientific advisers for advice on reducing the period, with a response expected within a week. Previous studies have suggested this can be done safely, if patients are required to have a negative test result before they are released.

Dr Leonard said on BBC Breakfast: ‘I’m very concerned. We’ve had two staff already go off – both double vaccinated and actually interestingly, neither of them were ill.’ She said one of the cases was discovered by a lateral flow test, adding: ‘She was very frustrated to have to go home for ten days.

‘We need to look at whether this ten-day isolation period is really necessary with more and more people going off sick… whether they could come back earlier when they’ve got a negative lateral flow test, because otherwise we’re going to have huge staff shortages in the NHS and the emergency services.’ 

‘Frequent attenders appear to be a major driver for the increase in consultations that have contributed to perceptions of increased workload in general practice.

‘GPs should be looking at this group of patients more closely to understand who they are and why they are consulting more frequently.’ The study, which looked at data from 845 GP surgeries, defined frequent attenders as those who visited their GP more than 90% of all other patients in the same practice.

In 2018-19 these took up 43 per cent of all appointments, compared to 38 per cent in 2000-01.

These ‘frequent attendees’ now see their GP on average 21 times a year, and have 60 consultations a year in total when including other practice staff, such as nurses taking blood pressure readings. This is around twice the number of appointments they had 20 years ago.

The study, published in BMJ Open, said many of the patients have ‘wider social and psychological needs’ that could not be met by GPs.

It added that demand from ‘frequent attenders’ meant GPs had to reduce face-to-face appointments for other patients even before the pandemic.

The Daily Mail is campaigning for more in-person appointments to tackle the crisis in GP care that has means millions of Britons are struggling to access their doctor.

Just 64 per cent of appointments are now in-person compared to 80 per cent before the pandemic.

Professor Martin Marshall, Chair of the Royal College of GPs, said: ‘As well as having more patients than 20 years ago, GPs and our teams are seeing more patients who are living with multiple, long-term conditions, who often require general practice care and services more frequently. 

‘As this research suggests, this is increasing the complexity of workload in general practice, as well as volume.

‘GPs know and understand their patients and we’re able to deliver the care our patients with complex health conditions need because of the relationships we’ve built with them over time. 

‘This is why it’s so important that we’re able to maintain continuity of care in general practice for those who need it, but this involves being able to spend more time with patients — and whilst demand for appointments is high, and staffing pressures in general practice prevail, being able to offer longer appointments in general practice, means being able to offer fewer overall.

‘GPs and our teams are working under intense resource and workforce pressures. These pressures existed before the pandemic, but the crisis has only exacerbated them.’

The British Medical Association is currently threatening industrial action over Government plans to ensure they see more patients in-person. 

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