GP full-time working should be defined as six sessions per week in order to reflect the ‘current duration of sessions’, a new study has concluded.
The authors argued that the BMA definition for full-time working is ‘inappropriate’ when compared to the NHS standard of 37.5 hours per week.
A cross-sectional study, based on GP Worklife survey results, found that the average number of hours worked per session has ‘significantly’ increased from 5.7 in 2010 to 6.2 in 2021.
This means that in 2021, the duration of sessions was around 50% higher than the BMA definition of a session, which is currently four hours 10 minutes.
To reach the NHS full-time standard of 37.5 hours per week, the BMA therefore recommends that a full-time GP works nine sessions.
But only 9.5% of GPs worked nine sessions per week in 2021, according to the study, which was based on a total of 7,340 survey respondents.
The authors argued that a ‘more appropriate definition’ would be six sessions per week, if sessions continue to be used as the measure of full-time working.
However, they concluded that the amount of work performed per GP session is ‘becoming increasingly underestimated’ and that sessions should no longer define full-time work.
Instead, they recommend using 37.5 hours per week in order to ‘align with the wider NHS’, which may also require a ‘readjustment of salaries’ since GP salaries are ‘primarily calculated’ using sessions worked.
Despite the increase in hours per session, the study revealed a decrease in mean sessions and mean hours per week between 2010 and 2021.
But the authors highlighted that in 2021, 54.6% of all GPs were working full-time hours per week, which is ‘much greater than the 25% figure’ reported in newspapers the following year.
| 2010 | 2012 | 2015 | 2017 | 2019 | 2021 | |
| Sessions per week | 7.27 | 7.22 | 6.90 | 6.72 | 6.57 | 6.24 |
| Hours per week | 40.50 | 41.30 | 40.86 | 40.23 | 39.73 | 37.98 |
| Hours per session | 5.67 | 5.82 | 6.03 | 6.08 | 6.13 | 6.22 |
They also found a ‘significant’ 11% increase in GP reported work intensity in 2021 compared with 2010, but noted that there has been a ‘steady decline’ since 2015 which indicates ‘mixed trends’.
On differences between GPs, the study revealed that partners ‘consistently worked significantly more hours and sessions and more hours per session and reported greater work intensity’ than other GPs.
However, the age of GPs had ‘minimal and inverse impact on hours and sessions per week’.
‘This indicates that younger GPs work more, despite a low desire to work full-time by trainee GPs,’ the authors claimed.
Definitions for full-time working
- NHS England – 37.5 hrs per week
- BMA – 9 sessions (lasting 4 hrs 10 mins)
- NHS Health Careers – 8 sessions
- UK Government – more than 35 hrs per week
- Office for National Statistics – more than 30 hrs per week
The study said: ‘The amount of work performed per session is becoming increasingly underestimated, which may lead to health planners underestimating the associated resources required for commissioning and employment changes.
‘As such, the authors recommend removing sessions as a definition of full- time working, instead using 37.5 hours per week to align with the wider NHS. This would equate to six sessions.’
It also warned that the ‘steady increase’ in the number of hours per session ‘may lead to a relative decline in the GP salary per hour, particularly for salaried and partner GPs’.
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Well, I think the ONS and UK Gov having a laugh, since the GMS contract defines 3/4 time as 19 hours per week, and full partner full-time as 26 hours per week, so acording to ONS, a GMS GP partner on 26 hours is working 4 hours a week less than full-time in their definition, so is being lazy; yet their surgery hours are 0800-1900 5 days a week, plus whatever they take home to do or dial in from home to sort out, etc, AND their CPD commitment, which in REAL hours comes to a minimum of at least 56 hours a week. or more than 13 ‘sessions’. But unlike Consultants, this does not include sleeping time on weekends.
On the other hand, seeing as you can’t do more than 2 sessions in a day, this explains why the weekly number of sessions done is falling. It seems we are doing more 11 hour days, but less days in total, which makes sense.
Meanwhile, the PT working pattern is abusing the session definition to make 1 session a day longer and longer, until it almost meets the 2-session full-day definition. We should be pushing for the first session to finish at 12MD, and the second session finish at 4pm, and anything after that is the third session!
Another bit of evidence that is aligning to support the feeling on the ground about workload and intensity.
Our junior Drs do expect workload control and a manageable day in General Practice and we are going to have to evolve to accommodate this and the BMA definition of safe working contacts probably helps bring us towards this and would allow 15 min appointments.
However if we are all to move to a 4 hour 10 min session with fixed contacts so this isnt exceeded our patients will expect a F/T GP to be in their practices Monday to Friday even if some of their sessions are admin/training/CPD etc.
We are probably heading for a salaried service in the not to distant future.
somewhere and at sometime there will need to be money vs workload out produced ie number of people seen vs NHS money paid. Made hugely more muddling by the number of people who provide services but in a ‘private sector this would determine workload/working week.
Comparing sessions in primary care vs consultants gets an even more muddling scenario and as yet consultant workload as opposed to sessions does not reflect in their pay (the recent HIT surgical list seeing 3 times as many patients show what can be done if the system is re engineered to work)
The public will need a huge degree of persuading that a GP earning a significant 6 figure salary (in England partners, not deprived areas i know )only needs to work 3 days when they cant get an appointment
Nine 4:10 sessions is 37.5 hours. If a session is longer or shorter than 4:10 then a different number of sessions will be needed to total 37.5 hours of work. If everyone defines terms used, and also details holiday entitlement and CPD provision per FTE we’d be able to compare properly. It should also be mandatory in my view to compare any GP offering with Consultant T&Cs to ensure parity.