In focus

Ten-minute appointments: It’s not surprising patients have unfinished business with their GP

Nearly half of us leave a doctor’s appointment without having discussed all our health concerns. It’s no wonder when we’re given 10 minutes and made to feel guilty for being there in the first place, writes Helen Coffey

Tuesday 03 September 2024 01:00 EDT
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Doctor who? Getting an appointment with a GP can take more time than patients bargained for
Doctor who? Getting an appointment with a GP can take more time than patients bargained for (Getty)

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There’s a special kind of irony to GP appointments these days. You must overcome countless obstacles to secure one: waiting on hold even when you were poised to ring the second the surgery opened; spilling your guts to the battleaxe of a receptionist, a gatekeeper more fearsome than any Tolkien dragon or mountain troll; describing your most excruciatingly embarrassing symptoms in a clinical online form; getting triaged over the phone by a total stranger who may as well be an AI chatbot. Then, having expended all that time and energy simply on getting seen, you’ve barely blinked before the whole thing is over, providing nothing more than the opportunity to repeat the whole saga to someone who’s clearly not read your notes.

The grand total of 10 minutes in the consulting room will be spent with, at best, a well meaning but overworked healthcare professional who’s already running 45 minutes behind schedule by 9am and doesn’t have time for anything but the most arbitrary of interventions. At worst, it will be spent with a not-so-well-meaning but overworked healthcare professional who makes it abundantly clear that your trifling ailments are just another drain on a chronically under-resourced NHS.

The other irony is that, by the time you get to see a doctor, weeks or sometimes months after the fact, the original health problem has often evolved into something else entirely and three brand new issues have reared their heads. But any notion you might have of “just mentioning that weird foot rash while I’m here” shrivels and dies under the glassy-eyed gaze of a person whose primary objective is to get you in and out as quickly as possible. Some surgeries have even brought in an official policy – “one problem per consultation” – to ensure you stick to the brief, all the more galling when you’ve had to wait an inordinate length of time to see anyone in the first place.

It’s little wonder that 40 per cent of Brits said they leave a GP appointment without discussing everything that was worrying them, according to a new survey. According to an Ipsos poll of 1,094 patients, two-fifths reported that there was not enough time during a 10-minute slot to bring up all their health concerns; respondents said they were only able to discuss “some things”, “hardly anything” or “nothing at all”.

Meanwhile, the vast majority (72 per cent) said they would prefer consultations to last at least 15 minutes, with 20 per cent of these clamouring for 20-minute appointments.

The Royal College of GPs, which has 54,000 members, didn’t disagree with the findings. “GPs share many of our patients’ frustrations outlined in this polling,” college chair Professor Kamila Hawthorne told The Guardian. “In fact, recent polling of our members found 60 per cent of GPs felt that they didn’t have enough time to adequately assess and treat patients.

“We need more time during consultations, particularly if a patient has complex health needs. We want to be able to treat our patients holistically and talk through all their health concerns. But with the current workload and workforce pressures facing GPs and our teams, we’re struggling to give our patients the time they need and the time we want to spend with them.”

GPs are under pressure to get patients in and out within 10 minutes
GPs are under pressure to get patients in and out within 10 minutes (Getty)

It’s a clearly far-from-ideal situation for both parties. Part of the problem stems from the number of hoops that must be jumped through to bag that initial consultation. The Ipsos poll revealed that 43 per cent of patients have to tell the receptionist about their problem before they can get an appointment, 31 per cent must first talk to a GP on the phone and 22 per cent have to fill in an online form. Unsurprisingly, 56 per cent claimed that they wanted GPs to make it easier to get an in-person consultation.

“Getting a GP appointment shouldn’t be some sort of test in persistence and digital skills,” agreed Rachel Power, chief executive of charity The Patients Association. “People’s mental and physical health is at risk of worsening if they can’t get support in a timely fashion.”

There are other detrimental ripple effects that come from 53 per cent of patients saying that shorter waiting times for appointments are needed. Clearly, in some cases, health issues may escalate in the meantime, or risk getting overlooked entirely. But, at the other end of the spectrum, time-strapped GPs are robbing Peter to pay Paul by inadvertently passing the problem on to other, equally overburdened parts of the NHS.

Getting a GP appointment shouldn’t be some sort of test in persistence and digital skills

Rachel Power, Patients Association

In 2021, 7.6 per cent of people who couldn’t get a GP appointment said they went to A&E instead – the equivalent of 282,000 people – according to analysis by charity IPPR. In 2023, this figure jumped to 12.2 per cent – the equivalent of 696,000 people.

The issue is also markedly linked to inequality. One in three people in poorer areas end up in A&E because they cannot obtain a GP appointment, and those from deprived areas are three times more likely than those in wealthy parts of the UK to face such problems. Research from a think tank at The King’s Fund published earlier this year concluded that poverty was placing added pressure on the NHS.

There is no easy solution – clearly the issue of struggling to obtain an appointment in a timely fashion will persist, at least in the short term. More than 5 million patients a month in England are waiting longer than two weeks to see their GP. But there are signs of hope at least, with Labour’s health secretary Wes Streeting pledging to divert billions of pounds from hospitals to GPs to “fix the front door to the NHS”, as well as promising that millions of patients will be able to see the same family doctor at every appointment.

Health secretary Wes Streeting has pledged to divert money to GPs
Health secretary Wes Streeting has pledged to divert money to GPs (PA)

In the meantime, there are things you can do to maximise your precious 10 minutes when you do manage to see a doctor. Make a list of what you want to discuss in advance so you don’t get flustered and forget, advises health and social care champion Healthwatch: “Write down details of your symptoms, including when they started and what makes them better or worse; write down any important questions you want to ask.”

If your surgery does allow for multiple problems, it’s also helpful to list each specific concern straight off the bat, kicking off with the most important one first. That way the GP can plan the time effectively; don’t wait till the end of your slot before saying “And while I’m here”, or “There were just a couple of other things”.

While it can feel tempting to bring up every single health issue that’s plaguing you, limit yourself to a maximum of three per session, says the Maltings Surgery. “Cramming in too much into 10 minutes is a false economy, making it more likely that the GP will make a mistake,” reads its advice. “If you have four items it’ll probably take you six to eight minutes to talk about all of them. The GP then has to think about each problem, examine you and prescribe the right treatment – all in a couple of minutes.”

And remember: you have every right to see your GP when health worries crop up. If dragons can be slain by mere mortals, there’s no reason you can’t take on that battleaxe of a receptionist and win.

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