Keywords: General Practice, Primary Care, Consultation, Consultation Complexity, Workload, Observational, Ireland

Background:

General practice (GP) is critical to healthcare provision in Ireland, yet little empirical evidence describes routine GP consultations. International studies suggest increasing consultation complexity, with multiple problems addressed per encounter. However, comparable Irish observational data are limited. Better understanding of consultation content, duration, and outcomes is needed to inform GP education, workforce planning, and service delivery.

Research questions:

This study examines the number and types of problems addressed in routine GP consultations; the timing of consultations and post-consultation workload; consultation outcomes (including new prescribing, referrals, investigations, and follow-up arrangements); and whether or not consultation characteristics vary by patient eligibility (public vs private), GP age or gender.

Method:

This prospective observational study is being conducted in Irish general practices affiliated with a GP training scheme. Five GP registrars each observe their supervising GPs during four routine clinical sessions. Adult patients (≥18 years) attending selected sessions are invited to participate following informed written consent. Using a structured proforma, observers record consultation duration, problems addressed (coded using ICPC-2 chapters), post-consultation administrative work, and consultation outcomes. There is no audio-visual recording. Data are anonymised and analysed descriptively. Approximately 150 consultations are expected.

Results:

Analysis of two datasets (n = 61) shows that multiple problems were commonly addressed within single consultations, with frequent initiation of new medications and arranged follow-up. Consultation length and problem load varied: patients with public entitlement had a median consultation duration of 12.5 minutes and two problems addressed, while private patients had a median duration of 14 minutes and three problems addressed. Consultations involving more problems tended to be longer. Further analysis will examine referral and investigation patterns and associations with GP characteristics.

Conclusions:

This study will provide observational evidence on the current structure and workload of routine GP consultations in Ireland, examining how patient characteristics, care eligibility, and GP characteristics are associated with consultation complexity.

Points for discussion:

Consultation complexity and workload by patient eligibility

Effect, if any, of GP age and gender

Implications for roll out of free GP care in Ireland (Slainte Care)