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During a recent morning surgery, I wondered how much time could be saved if I did not have to make notes that I would feel confident defending in court after every consultation. I searched the literature for examples of UK GP consultations and found Sinnott et al’s1 paper titled ‘Identifying how GPs spend their time and the obstacles they face: a mixed-methods study’. This excellent study, where the authors observed over 238 hours of GP session time with 61 GPs at 28 NHS practices in England from 2018–2019, provided many insights into how GPs spend their time.
The authors recorded time spent ‘documenting/updating electronic health record’ (EHR) but grouped this activity with other ‘direct care’ tasks (see Box 1 in Sinnott et al). I wrote to Dr Sinnott enquiring if the time spent just ‘documenting/updating electronic health record’ was available and they were kind enough to retrieve this information:
‘The total time spent documenting/updating EHRs was 34:13:40 (h:m:s). But after removing those documenting/updating EHR tasks that were themselves related to interruptions, the adjusted time spent documenting/updating EHRs was 34:08:58. Time spent on direct-care tasks was 172:24:14, meaning documenting/updating EHRs took approx. 19.8% of direct care time.’
This would equate to approximately 14.4% of total GP time observed (34:13:40/238:04). When adjusting for time spent multitasking, this estimate is reduced to 13.9% (34:13:40/245:35:42 — see Table 2 in Sinnott et al). Limitations of this analysis include instances where patients declined the presence of a research observer during consultations. Additionally, the authors highlight that they did not measure the time GPs spent outside of their scheduled sessions (for example, before sessions, during lunch breaks, after sessions), which, sadly, constitutes a significant proportion of many GPs’ current workload.
As I could not find this important information reported elsewhere, I thought it should be shared with the BJGP readership, as it provides valuable insights into potential GP efficiency savings such as routinely audio-recording all consultations2 and storing these as part of medical records, using in-person ‘medical scribes’,3 or the use of artificial intelligence (AI) to automatically generate consultation notes from recordings, known as ‘digital scribes’ or ‘AI scribes’.4
Acknowledgments
I thank Dr Sinnott and colleagues for sharing this additional data and granting me permission to share the information in this letter with the BJGP readership.
Notes
Funding and disclaimer
Dr Edwards’ time is funded by a National Institute for Health and Care Research (NIHR) In-Practice Fellowship (NIHR302692). The views expressed are those of the author and not necessarily those of the NIHR or the Department of Health and Social Care.
- © British Journal of General Practice 2024
