2 December 2002
Why doctors have less time for patients
A new study of delays in a London outpatient clinic has found that over 40% of time was lost in "administration and inefficiency", with doctors spending nearly three minutes less time with their patients than they did thirteen years ago. The research, published in the December Journal of the Royal Society of Medicine, was carried out by Mr Hiten Patel and colleagues at the Whittington Hospital NHS Trust. They looked at a breakdown of delays during 167 consultations in a general urology follow-up clinic. The results highlighted that the structure and resources of the clinic were not really adequate. The authors recommend that for outpatient clinics to cope with recent Government demands for shorter waiting times, there has to be investment in information technology and support staff.
Survey results
The
study recorded times for discussion, examination, reading
notes, administration, finding missing results, and
other interruptions or disturbances. Results were compared
with a similar study carried out in 1988.
- The average length of a consultation was 8.2 minutes. Only 4.8 minutes were spent with the patient, compared with 7.6 minutes thirteen years ago.
- 41% of consulting time was spent away from the patient. 17% was spent on administration, 15% on disturbances from the telephone or other staff, and 9% on finding results.
- In a quarter of consultations, delays were caused by missing results or other records.
Why are delays getting worse?
The article points out that "the most conspicuous waste
of time is in hunting for missing notes or results," mainly
because of delays in typing reports where appropriate.
Other delays are caused by administration, which might
be improved by computerization, and by interruptions.
In the Whittington hospital, one-stop clinics run by
nurse practitioners were introduced to allow consultants
more time with their patients, but nurses still needed
supervision and advice, which interrupted doctors' consulting
time with other patients.
The authors conclude that if inefficiencies could be cut by half, consultants could spend more time with patients or "throughput could be increased by one-third".
Further new research on NHS delays is published in a separate article in the December JRSM. Read more here.
ends - 2 December 2002
Read the full article [PDF 59k]
