‘Frequent attenders’ comprise 4 in each 10 household physician consultations in England

‘Frequent attenders’ now make up round 4 in each 10 household physician (GP) consultations in England, and the proportion of such sufferers has risen over the previous 20 years, reveals a big long run examine printed within the open entry journal BMJ Open.

Frequent attenders go to their GP 5 instances as typically as different sufferers on a basic apply record, serving to to elucidate the perceived rise in GP workload, reveals the evaluation of practically 1.7 billion consultations over 20 years.

GPs within the UK have repeatedly sounded the alarm on the fast will increase of their workload in recent times, prompted by an ageing inhabitants, the complexity of care wants, and initiatives to shift care from hospitals into the group.

However there’s been little printed analysis on present workload charges usually apply within the UK, notably the contribution made by ‘frequent attenders.’

Preliminary information recommend that the highest 10{58e281ace639831ddb6d8687333e7c2b02e87c7c548a0119c43312a5ff3c7894} of attenders could possibly be liable for between 30{58e281ace639831ddb6d8687333e7c2b02e87c7c548a0119c43312a5ff3c7894} and 50{58e281ace639831ddb6d8687333e7c2b02e87c7c548a0119c43312a5ff3c7894} of all GP consultations.

To discover this additional, the researchers got down to analyse the sort and distribution of consultations inside basic practices and apply lists, specializing in frequent attenders, over a interval of 20 years.

They drew on anonymised data on 1.7 billion consultations with 12.3 million sufferers, submitted to the Scientific Observe Analysis Database by 845 GP practices throughout the UK between April 2000 and March 2019. Solely 113 practices contributed information all through all the examine interval.

They checked out consulting patterns among the many prime 10{58e281ace639831ddb6d8687333e7c2b02e87c7c548a0119c43312a5ff3c7894} of consulting sufferers with: all employees, together with admin employees, within the apply; solely with GPs, to incorporate head to head, distant, and telephone consultations; in addition to head to head consultations with all employees, and solely with GPs.

All kinds of consultations with all employees in a apply greater than doubled, rising from an annual common of 11 per particular person in 2000–01 to 25 in 2018–19; for GPs the equal figures have been an annual common of 5 in 2000-01 to eight per particular person in 2015-18.

Amongst frequent attenders, all kinds of consultations with GPs rose from a mean of 13 to 21 a yr whereas these with different apply employees rose from a mean of 27 a yr to 60 between April 2000 and March 2019.

In all, round 4 out of 10 consultations of any kind involved frequent attenders, and the proportion of consultations attributed to them elevated over time, notably for head to head consultations, charges of which fell amongst different sufferers.

The proportion of head to head consultations with GPs amongst frequent attenders rose from a mean of 38{58e281ace639831ddb6d8687333e7c2b02e87c7c548a0119c43312a5ff3c7894} in 2000–01 to 43{58e281ace639831ddb6d8687333e7c2b02e87c7c548a0119c43312a5ff3c7894} in 2018–19, and from a mean of 38{58e281ace639831ddb6d8687333e7c2b02e87c7c548a0119c43312a5ff3c7894} to 40{58e281ace639831ddb6d8687333e7c2b02e87c7c548a0119c43312a5ff3c7894} for all apply employees.

Frequent attenders consulted round 5 instances extra typically than the remainder of the apply record, on common.

There was comparatively little regional variation in any of the traits studied, the one exceptions being head to head consultations with GPs, which have been highest in Scotland and head to head consultations with all employees, which have been highest in Northern Eire.

And frequent attendance charges did not appear to be influenced both by space ranges of deprivation or the apply. However proof from Europe signifies that frequent attenders usually tend to be feminine, older, have extra social and psychiatric issues, taking extra medication for psychological sickness, have extra medically unexplained signs, and extra long run situations, word the researchers.

That is an observational examine, and as such, no agency conclusions will be drawn about trigger and impact. And the researchers acknowledge that they used their very own definition of frequent attenders.

However the findings echo these of Dutch research, they are saying, and recommend “{that a} comparatively small variety of sufferers are accounting for a big proportion of GP workload together with face-to-face consultations.”

They conclude: “Frequent attenders look like a significant driver for the rise in consultations which have contributed to perceptions of elevated workload usually apply.

“GPs ought to be this group of sufferers extra carefully to know who they’re and why they’re consulting extra regularly.”