More time for complex consultations in a high-deprivation practice is associated with increased patient enablement

Background
Evidence of the beneficial effects of longer consultations in general practice is limited.
Aim
To evaluate the effect of increasing consultation length on patient enablement in general practice in an area of extreme socioeconomic deprivation.
Design of study
Longitudinal study using a ‘before and after’ design.
Setting
Keppoch Medical Centre in Glasgow, which serves the most deprived practice area in Scotland.
Method
Participants were 300 adult patients at baseline, before the introduction of longer consultations, and 324 at follow-up, more than 1 year after the introduction of longer consultations. The intervention studied was more time in complex consultations. Patient satisfaction, perceptions of the GPs’ empathy, GP stress, and patient enablement were collected by faceto-face interview. Additional qualitative data were obtained by individual interviews with the GPs, relating to their perceptions of the impact of the longer consultations.
Results
Response rates of 70% were obtained. Overall, 53% of consultations were complex. GP stress was higher in complex consultations. Patient satisfaction and perception of the GPs’ empathy were consistently high. Average consultation length in complex consultations was increased by 2.5 minutes by the intervention. GP stress in consultations was decreased after the introduction of longer consultations, and patient enablement was increased. GPs’ views endorsed these findings, with more anticipatory and coordinated care being possible in the longer consultations.
Conclusion
More resource to provide more time in complex consultations in an area of extreme deprivation is associated with an increase in patient enablement.