Twenty minutes for some
Twenty minutes for all
Plan ahead or just do it
For consultation length the UK is an outlier, with shorter GP consultations than most countries. Over the last twenty years Uk consultations have moved from seven minutes to an average of twelve minutes. At the same time the consultation has become more complex with most chronic conditions managed in primary care. Longer consultations have been shown to be more patient centred, but in the UK there are disincentives to a longer consultation. Policies do not actively support a model of longer consultations and general practitioners are not aware that a twenty minute model of consultation can work in practice.
Twenty minutes for some
Twenty minute appointments can be given to patients for any doctor, on an as needed basis, by combining shorter slots.
Patients could select five, ten or fifteen minute consultation length. This may be time neutral if five minute and 20 minute consultations balanced out.
All GPs could designate some patients to always be given double appointments. This would be if they usually have complex consultations for whatever reason.
Twenty minutes for all
In the UK, the balance is between appointment provision and appointment length. All doctors in the UK could go to twenty minute appointments if they gave less appointments. Not an easy choice, but potentially possible if Primary Care network additional roles take on more appointments
All doctors can move to twenty minute appointments if they accept a reduced income and then paid others to provide extra appointments. (Or work longer days which is near impossible given the current GP workload)
Doctors who retire or have other sources of income could all move to twenty minute appointments. A national model for this could help retain GPs in the NHS, improve GP wellbeing, as well as help rebuild and maintain an experienced NHS workforce.
Plan ahead or just do it
The options are to make change and negotiate issues arising……. or you can negotiate change and more proactively tackle issues that might arise. The former may achieve change, but lead to risk of conflict and misunderstanding. The latter may not achieve change at all and still risk conflict, but there may be less misunderstanding.
Clarity about appointment numbers and changes are needed on a monthly basis. Distinguishing previously agreed processes (green in reports) from new applications for time out of surgery (red in reports) gives more clarity.
A process of checking needs to be in place so it is clearly a fair process when GPs with longer appointments and more sessions work alongside those with shorter appointments and fewer sessions.