Background Demand for GP services in the Republic of Ireland (RoI) is increasing, and the resultant escalation in workload demands is an issue of growing concern. Accordingly, the accurate measurement and description of GP workload is essential to inform future healthcare planning. Aim To provide a real-time measurement of GP workload with respect to hours worked and of proportional time expenditure on typical workload activities. Design and setting A prospective study among GPs in the RoI that took place from January 2019 to March 2019. Method Participants were invited to enrol in the study by direct email invitation and via notifications posted within GP-specific monthly journals; online forums; and a social media platform. Participants used a time-management software program to self-record workload activity in real time over 6 weeks. Results In total, 123 GPs were included for final analyses with a total of 8930 hours of activity recorded. The mean duration of a two-session day (excluding break-time) was 9.9 hours (95% confidence interval [CI] = 9.7 to 10.0; interquartile range [IQR] 7.9 to 13.9). Of this time, 64% was spent on clinical consultations. In total, 25.4% of activity was recorded outside the hours of 9.00 am and 5.00 pm. An average of 12.4 face-to-face consultations were completed per session of activity. The mean duration of a 10-session week was greatest for the partner (50.8 hours; 95% CI = 49.8 to 51.9) and >55-year-old (50.8 hours; 95% CI = 49.3 to 52.2) demographics, relative to their respective colleagues. Conclusion To the authors’ knowledge, this is the first study to provide an objective, accurate, and granular real-time measurement of GP workload in the RoI, demonstrating the significant volume and variety of work undertaken by GPs in the RoI.

Background Optimising child health in general practice is a key health service priority. In Ireland, where 23% of Ireland’s population are aged under 16, GP consultations have historically involved a private fee or have been covered by Ireland’s General Medical Services (GMS) scheme. In July 2015, this scheme was expanded so that free GP care was provided to all children aged under 6 years. Recent research suggests this change in policy has led to a substantial increase in the number of children under six attending both daytime and out-of-hour GP services and highlights a need to better understand the perspectives of GPs on this policy change. Aim To address these knowledge gaps, this paper aims to examine GPs’ views on the scheme and how it has impacted on their practice. Methods Sixteen GPs participated in semi-structured telephone interviews between June and August 2016, analysed using inductive thematic analysis. Results Six key themes were identified: (1) increased service utilisation, (2) changes in parental behaviour when accessing services, (3) increased ‘out of hours’ service utilisation, (4) dissatisfaction with the current resourcing of the scheme, (5) limited capacity to support expansion of free GP care, and (6) reduced antibiotic prescribing. Conclusions The study highlights how introducing free GP care to a mixed private/publicly funded health system may impact on GP workload, parents’ interaction with services and physician practice.

While considerable changes are happening in primary care in Ireland and considerable potential exists in intelligence derived from practice-based data to inform these changes, relatively few large-scale general morbidity surveys have been published.

With the introduction of free point of access GP care for children aged under six imminent, we sought to determine consultation rates among this group. We interrogated data from practice management systems at six general practices (total patient population 27080). A total of 1931 children aged under six were responsible for 5814 surgery consultations. The mean annual consultation rate was 3.01; 4.91 for GMS' patients, 5.07 for 'Doctor Visit' patients and 2.03 for private patients. Our findings suggest the introduction of free GP care for children under six will considerably increase GP consultations. We also highlight the value of routinely collected general practice data in facilitating health services planning. We estimate that there will be an additional 750,000 GP consultations annually.

Accurate data on primary care activity is key to health services planning and reconfiguration. Official data estimate general practice adult consultation rates to be 3.2 visits annually, based on patient self reports. We aim to estimate the consultation rate using practice based data and compare this to official estimates. We interrogated six general practices' information systems and estimated consultation rates based on practice, telephone, domiciliary and out of hours consultations by patients aged 18 years or older. The study population (20,706 patients) was representative of the national population in terms of age and GMS status. The mean consultation rate was 5.17, though this was higher among GMS-eligible patients and among older age groups. Estimates of consultation rates derived from practice based data are likely to be higher than that derived from other approaches. Using multiple sources of data will enhance accuracy of workload estimates and this will benefit service planning.