GPs spending longer with patients is more cost effective than many prescription drugs, a Scottish study has revealed.

The groundbreaking investigation saw four surgeries in Glasgow offer patients with complicated health problems appointments which lasted half an hour or more.

Those who received this extra attention were better a year later than a group of similar patients who received a standard service from their GP - which typically consists of 10 minute appointments.

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During the extended consultations GPs dealt with all the patients' issues, agreed a care plan with them and goals to aim for. Follow-up sessions were also arranged to see how people were getting on.

Professor Graham Watt, an expert in general practice at Glasgow University, said: "To everyone's surprise and delight it proved to be cost effective. If this was a drug or a bit of equipment it would just sale in - there would be no argument about whether the NHS should be doing it."

The findings were published as the British Medical Association in Scotland warned the Scottish NHS does not have enough money to provide the services people need over the next five years unless the way people are looked after changes rapidly.

Eight practices in deprived parts of Glasgow were recruited to the GP experiment. Four health centres in Drumchapel, Possilpark, Tollcross and Parkhead offered the enhanced care programme called CARE Plus while the other four kept services the same. The GPs and practice nurses who delivered CARE Plus received training and the surgeries were given money to hire locums, releasing the usual doctors to spend time on the extended consultations.

After a year, the 76 patients who received CARE Plus scored higher on questionnaires about their mood. They were also in better health than the comparison group of 76 patients at surgeries without CARE plus. All those involved in the research had complicated health issues, with an average of five different problems.

Professor Watt said: "CARE Plus showed a difference, but not so much because the patients who got the extra time got better. It was because the patients who did not get it, got worse. It shows that if primary (GP) care isn't well resourced and up to speed then things are just going to fall apart and patients will turn up in accident and emergency faster than they need to."

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CARE Plus cost £929 more per patient than the standard GP service, including staff training expenses and locum cover. Health economists conducted the same cost benefits analysis which is applied to new drugs to judge if they represented value for money. They calculated a bill of £12,224 for every "quality adjusted life year" (qaly) gained - this compares to a threshold of £20,000 per qaly which is often used to help decide if new treatments should be prescribed on the NHS.

Professor Stewart Mercer, who led the research and holds the chair in primary care research at Glasgow University, said: "The exciting thing is it is possibly the first evidence that if you just support staff - without bringing in new staff - it is actually cost effective on the government's own guidelines."

The study, which has been published in the open access journal BMC Medicine, is described as exploratory and there are plans to undertake further research involving GPs in Glasgow, Liverpool, Manchester and Bristol.


The Scottish Government has £9.5m to distribute this year to trial new ways of looking after people in the community.

Dr Peter Bennie, chair of BMA Scotland, told the UK conference of BMA members : “We all live in times of austerity across the four nations of the UK.

“Health budgets, although relatively protected, have been virtually static in real terms since 2010 and will struggle to cover the increasing health requirements of our people in the coming years.

“This funding gap is just as real in Scotland as elsewhere.

“Yet there is a tendency for politicians, media, even doctors, to tacitly accept this as an unavoidable reality."

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He called on the Scottish Government must take immediate action to find a way to deliver more sustainable services for the long term.