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Feature Healthcare Improvement

Can GPs find time for a million extra appointments a year?

BMJ 2019; 365 doi: (Published 07 May 2019) Cite this as: BMJ 2019;365:l1999
  1. Ann Robinson, general practitioner, London, UK
  1. drannrobinson{at}

NHS England makes grand claims about the potential impact of its Time for Care programme, which has GPs leading efficiency drives in primary care. Ann Robinson examines whether the savings are realistic

A pilot scheme to introduce a plethora of more efficient working practices in general practice has freed up half a million hours of GPs’ time that could be used to see patients instead, NHS England claimed recently.1

Examples included introducing electronic prescribing or online appointment booking and using allied healthcare professionals instead of GPs to see patients (see for more).

NHS England reckons its Time for Care programme has saved 205 157 clinical hours and 330 096 administration hours.2 Extrapolating these results nationwide, GPs could offer an extra 1.23 million appointments a year, it says, the equivalent of £40m (€47m; $52m) a year (assuming each 10 minute appointment costs £30).

But are such savings overly optimistic? The NHS is already considered one of the world’s most efficient health systems,3 and many general practices have recently introduced efficiency improvements. Without a recruitment boost many GPs could consider it unreasonable to see more patients: the average GP already works well above the BMA’s recommended daily safe limit of 35 appointments.45 And what are the long term results on GPs’ workload of offering more non-GP appointments, for example?

Time for Care

Spawned from NHS England’s 2016 General …

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