ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2022
Identifying how GPs spend their time and the obstacles they face: a mixed-methods study.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
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- Experiences of access to general practice in England: qualitative study and implications for the NHS 10 year plan.BMJ (Clinical research ed.) · 2026Article
- Does ambient voice technology in healthcare really save time? The need for rigorous evaluation to test the promise.BMJ digital health & AI · 2026Article
- Competing epistemologies: a reflexive thematic analysis of research in general practice.BMC primary care · 2025Article
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- Labour's 10 year plan for the English NHS.BMJ (Clinical research ed.) · 2025Article
- On Lateness: The Ethics of Running Behind Schedule in General Practice.Journal of evaluation in clinical practice · 2025Article
- Factors affecting cancer care delivery in primary care: a qualitative study.Family practice · 2025Article
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- Balancing specialist roles with generalist responsibilities in primary care: have we gone too far?Frontiers in health services · 2025Article
- Effects of COVID-19 on Irish general practice activity from 2019 to 2021: a retrospective analysis of 500,000 consultations using electronic medical record data.Irish journal of medical science · 2024Article
- General practitioner workforce sustainability to maximise effective and equitable patient care: a realist review protocol.BMJ open · 2024Article
- GPs spend 14% of their session time documenting consultation notes and updating electronic health records.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- Operational failures in general practice: a consensus-building study on the priorities for improvement.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- The real work of general practice: understanding our hidden workload.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- The performance of general practice in the English National Health Service (NHS): an analysis using Starfield's framework for primary care.Health affairs scholar · 2024Article
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Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough problems that impair task completion - known as operational failures - are an important focus of concern in primary care, they have remained little studied.
aimTo quantify the time GPs spend on different activities during clinical sessions; to identify the number of operational failures they encounter; and to characterise the nature of operational failures and their impact for GPs. DESIGN AND
settingMixed-method triangulation study with 61 GPs in 28 NHS general practices in England from December 2018 to December 2019.
methodTime-motion methods, ethnographic observations, and interviews were used.
resultsTime-motion data on 7679 GP tasks during 238 hours of practice in 61 clinical sessions suggested that operational failures were responsible for around 5.0% (95% confidence interval [CI] = 4.5% to 5.4%) of all tasks undertaken by GPs and accounted for 3.9% (95% CI = 3.2% to 4.5%) of clinical time. However, qualitative data showed that time-motion methods, which depend on pre-programmed categories, substantially underestimated operational failures. Qualitative data also enabled further characterisation of operational failures, extending beyond those measured directly in the time-motion data (for example, interruptions, deficits in equipment/supplies, and technology) to include problems linked to GPs' coordination role and weaknesses in work systems and processes. The impacts of operational failures were highly consequential for GPs' experiences of work.
conclusionGPs experience frequent operational failures, disrupting patient care, impairing experiences of work, and imposing burden in an already pressurised system. This better understanding of the nature and impact of operational failures allows for identification of targets for improvement and indicates the need for coordinated action to support GPs.
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