Intended for healthcare professionals

Rapid response to:

Views And Reviews Acute Perspective

David Oliver: Does doctors’ admin take up too much time?

BMJ 2019; 367 doi: (Published 13 November 2019) Cite this as: BMJ 2019;367:l6381

Rapid Response:

Yes! Does anyone doubt it?

The purpose of healthcare is healthcare - not administration.

Of the 168 hours in the week about 60 will be spent asleep, perhaps 20 on feeding, ablutions and travel, one would hope that CPD got a regular look in - say 5 (- or should that be part of the contracted hours?), would 25 be too much time to spend with home and family? That leaves about 58 hours for work - for the sake of discussion we will disregard the EWTD. Work might include any or all of leadership/management/mentoring/teaching/research roles as well as direct patient contact and then there is the vast catalogue of additional burdens that David Oliver mentions.

A forty hour per week full time career path ought to involve at least 90% of the contracted hours in direct clinical contact with patients. Calls for more doctors would be far less pressing if doctors were actually allowed to do doctoring.

Perhaps in future negotiations between profession and employers limits should be set on weekly commitments to non-clinically productive tasks - say 10% or four hours. If management wants new non-clinical tasks performed then something already on the list has to go to make way.

If doctors and nurses were allowed to do doctoring and nursing for 90% of their contracted hours then many millions of hours of additional clinical work would be accomplished annually.

Admin has become damagingly dominant - for both professionals and patients. Limits must be set.

Competing interests: No competing interests

17 November 2019
Steven Ford
Retired GP
Steven Ford
Five Stones