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The RCGP encourages the shift to longer appointments to support the care of the ageing population with its polymorbidities.1 However, there is a counter-pressure from the NHS in England towards ensuring a minimum number of appointments per thousand patients. The recommendation is currently 72 appointments per thousand patients per week. Some clinical commissioning groups have provided practices with software to monitor appointment availability.
Mental health disorders are generally not well recognised or managed in primary care.2–5 The Centre for Mental Health reports that the societal impact of mental health problems in purely monetary terms was £34.9 bn in 2016/2017 in the UK.
The shift towards minimum number of weekly appointments presents a volume versus quality conflict and where the volume paradigm prevails it is likely that the care of patients with complex needs, including mental health disorders, or polymorbidities will be less well served. Likely too is an undermining of GP resilience and an exacerbation of shortfalls in the GP workforce.
- © British Journal of General Practice 2020
