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Evolving general practice consultation in Britain: issues of length and context

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Freeman, George K, Horder, John P, Howie, John G R, Hungin, A Pali, Hill, Alison P, Shah, Nayan C, Wilson, Andrew·2002·BMJ

DOI 10.1136/bmj.324.7342.880PMC PMC101402

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Abstract

In 1999 Shah 1 and others said that the Royal College of General Practitioners should advocate longer consultations in general practice as a matter of policy.The college set up a working group chaired by A P Hungin, and a systematic review of literature on consultation length in general practice was commissioned.The working group agreed that the available evidence would be hard to interpret without discussion of the changing context within which consultations now take place.For many years general practitioners and those who have surveyed patients' opinions in the United Kingdom have complained about short consultation time, despite a steady increase in actual mean length.Recently Mechanic pointed out that this is also true in the United States. 2 Is there any justification for a further increase in mean time allocated per consultation in general practice?We report on the outcome of extensive debate among a group of general practitioners with an interest in the process of care, with reference to the interim findings of the commissioned systematic review and our personal databases.The review identified 14 relevant papers. Summary pointsLonger consultations are associated with a range of better patient outcomes Modern consultations in general practice deal with patients with more serious and chronic conditions Increasing patient participation means more complex interaction, which demands extra time Difficulties with access and with loss of continuity add to perceived stress and poor performance and lead to further pressure on time Longer consultations should be a professional priority, combined with increased use of technology and more flexible practice management to maximise interpersonal continuity Research on implementation is needed

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Authors: Freeman, G. K., Horder, J. P., Howie, J. G. R., Hungin, A. P., Hill, A. P., Shah, N. C., & Wilson, A.
Affiliations: Imperial College London (GB)
Corresponding author: Freeman, George K
ORCID: Freeman, George K
Hungin, A Pali
Venue: BMJ
Publisher: BMJ
Published: 2002-04-13
Volume: 324
Issue: 7342
Pages: 880-882
ISSN: 0007-1447 (ISSN-L)
0959-8138
1468-5833
DOI: 10.1136/bmj.324.7342.880
PMC: PMC101402
OpenAlex: W2151816860
Cited by: 195
References: 22
Citations by year: 2026: 4 · 2025: 2 · 2024: 1 · 2023: 3 · 2022: 5 · 2021: 1 · 2020: 5 · 2019: 5 · 2018: 2 · 2017: 11 · 2016: 3 · 2015: 6 · 2014: 15 · 2013: 10 · 2012: 7
FWCI: 36.36
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
Locations: BMJ (publishedVersion)
PubMed Central (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed (publishedVersion)
Leicester Research Archive (University of Leicester) (submittedVersion)
DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Funders: Royal College of General Practitioners
Topics: Health Sciences › Medicine › Family Practice › Primary Care and Health Outcomes
Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Systems and Technology
Keywords: consultation time, general practice, primary care, patient outcomes, patient participation, continuity of care, health care access, general practitioners, practice management, health technology, Royal College of General Practitioners
MeSH terms: Family Practice, United Kingdom, Humans, Office Visits, State Medicine, Time Factors, Patient Satisfaction

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Evolving general practice consultation in Britain: issues of length and context

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