Time changes consultations

The proportion of primary care consultations conducted by telephone has trebled over the past 14 years, according to the largest ever study of trends in consultation rates.

In 1995, 3% of GP practice consultations were conducted over the telephone; but by the end of 2008 the figure had risen to 12%. At the same time, consultations conducted in the surgery fell from 86% to 82% and home visits from 9% to 4%.

The changing face of consultations is revealed in a report based on the QResearch database, commissioned by the NHS information Centre on behalf of the Department of Health and the Office of National Statistics and published this week.

The QResearch database has been developed by Nottingham University and primary care IT system supplier EMIS. IT contains more than 40m records from 573 GP practices, with data going back to the early 1990s.

The researchers found the estimated number of consultations for a typical practice in England rose from 21,100 in 1995 to 34,200 in 2008 and that the average patient had 3.9 consultations each year in 1995 rising to 5.5 consultations each year by 2008.

The report says the decline in home visits is likely to reflect changes in the delivery of our-of-hours care over the past 14 years, including the formation of co-operatives for out-of-hours services and the removal of out-of-hours care from GP contractual responsibilities.

It also found the number of consultations carried out by nurses rose from 21% in 1995 to 34% in 2008, although the report’s authors said the figures “could easily reflect an increase in recording on computer by nurses as well as a true increase in the total numbers of patients seen by a nurse each year.”

The analysis was based on 108 general practices (919,000 patients) in 1995 and for 503 practices (4.4m patients) in 2008. The average practice had 8,712 registered patients.