Intended for healthcare professionals

Rapid response to:

Head To Head

Should GPs’ daily number of consultations be capped?

BMJ 2018; 361 doi: (Published 09 May 2018) Cite this as: BMJ 2018;361:k1947

Patient commentary

General practice needs radical reform, not tweaks like consultation caps

Rapid Response:

Re: Should GPs’ daily number of consultations be capped?

Having a general idea of what is a safe consultation load does not affect professional competence. Think of it like a speed limit - there are safe limits to consulting as well but doctors get used to thinking that they can cope with everything.

We know, from “burn out” data and from the increasing numbers of GPs accessing health lines, that this is not the case.

A UEMO (European Union of GPs) survey looked at those countries that considered general practice workload, in their state, to be reasonable and sustainable. They had certain factors in common, lower lists, shorter working days, longer consultation times but the strongest correlation was that they saw fewer than 25 patients a day.

There is some evidence that a high volume of work is associated with poorer patient care and that 20 consultations a day should be a ceiling figure. This evidence unfortunately comes from American Journals of Veterinary Medicine but I feel the principle holds good. If care is diminished for pets by seeing a high volume of clients, possibly the same holds true for humans.

We are not saying GPs should never see more than 25 patients in one working day.

We are saying that if a GP consistently and regularly sees a high volume of patients in one day, it is not safe for the doctor nor their patients.

Competing interests: No competing interests

14 May 2018
Mary McCarthy
Belvidere Medical Practice. SY2 5LS