The GP practice where patients can share appointments

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Faced with a wait for a GP appointment, would you choose a group session with the doctor instead? It is an idea some surgeries are investigating.

Demand for appointments increasingly outweighs availability. In recent years, the number of GP appointments has risen by 13%, but GP numbers are up by less than 5%, putting huge pressure on surgeries.

In addition, many of us are living longer and with multiple long-term conditions, which can make consultations extremely complex.

The traditional one-to-one 10-minute appointment is arguably no longer fit for purpose.

With no promise of increased funding, or a substantially increased GP workforce, primary care teams have to find innovative new ways of delivering routine care in general practice that simultaneously save time and improve quality.

One such practice is Parchmore Medical Centre in Thornton Heath, Surrey.

Anthony is a patient there. He says: “I’ve passed that magical age of 50 and got a call from the GP. I’ve got some weight issues and some blood pressure issues, so it’s time to do something.”

He had come in for an appointment – but one with a difference. Instead of the usual 10 minutes, he was going to have an hour-and-a-half with his GP.

But he would not be seeing the doctor alone; he would be sharing his appointment with six other patients.

‘No-one felt the need to hold back’

They all have weight issues and/or pre-diabetes. There were seven present at this particular consultation, but as many as 15 can attend.

The session started with a doctor’s assistant – the “facilitator” – collecting the patients’ measurements and compiling a list of questions they wanted to ask the doctor.

The test results – including body mass index (BMI), body measurements and blood pressure – were then written up on a board in the room, so that GP Dr Alex Maxwell could lead a discussion around them.

The group also spoke about sensitive issues such as gut problems, their relationship with food and their mental wellbeing.

The aim of sessions like this is to give patients more information about their condition because they learn from the doctor and each other, as well as ensuring the GP’s time is used efficiently.

Anthony says it is not constraining to have other people in the room. “In fact, it was quite the reverse – once the group got going, we almost formed a bit of a bond in there and everybody was quite open, I don’t think anyone felt the need to hold back at all.”

Other patients said the group session meant more time with the GP than a one-to-one appointment would allow, and that sharing experiences with others with the same condition could be empowering.

But there are obvious fears. Could this be the thin end of the wedge – the beginning of the end for the one-to-one appointment?

Peer support

Both the Royal College of GPs and the Patients’ Association say that while this kind of scheme might work for some, patients should still have the option of the traditional one-to-one appointment if they want it.

Dr Emily Symington, from the NHS Croydon Clinical Commissioning Group (CCG), which includes the Parchmore practice, said there was no plan to end conventional appointments.

“Replacing the one-to-one appointment is certainly not something that we are looking to achieve or anticipating at all.

“Also, a group consultation is for patients who already have a diagnosis.

“No-one is ever going to be diagnosing you in a group – that wouldn’t be appropriate. Group consultation adds something extra.”

She says there are measures in place to ensure the confidentiality of information shared within the group, and patients who attend can still request and receive a one-to-one appointment.

But group appointments could bring real benefits for patients managing long-term health conditions – offering more access to your doctor, with a valuable peer support network included.