Practice staff stand accused of being disconnected from the level of patient demand.
Dr Rupert Dunbar-Rees, a former GP and Director of Healthcare Advisory at BDO Alliance, told Management in Practice practices have to go "back to basics" if they want to better manage patient demand.
"Most capacity in primary care is delivered around historical cultural norms – ie when the GP wants to be on call with their time scheduled around other commitments," he said.
"There is almost a complete disconnect with how capacity is supplied in general practice and what the patient demand is."
Dr Dunbar-Rees said most practices are guilty of using "finger in the air" judgments to shape primary care when there are many "simple quick five-minute exercises" – such as examining telephone reports - that can be used to better understand patient behaviour.
However, Dr Richard Vautrey, Deputy Chair of the British Medical Association's GP Committee, argued the only way primary care capacity can catch up with patient demand and expectation is with more GPs on the payroll.
"Consultation rates are increasing at a steady level as more and more patients seek the support of a GP," he said.
"Existing GPs are already working flat out and simply re-jigging practice hours will not work.
"The bottom line is we need more GPs."
Dr Dunbar-Rees also criticised the practice of embargoing appointments as a way of reducing the burden on GPs.
"Practices embargoing appointments does not solve the problem with demand long-term," he said.
"Doing so only creates angst at reception and drives a perception of scarcity of services, leading to patients overbooking in advance.
"It is about working smarter, not necessarily harder."
By Louise Naughton
"More GPs certainly not the answer. I would agree some 'back to basic' principles can be applied here with re-education and at times a transparent honest explanation delivered professionally. Patients need re-educating. The dependency culture must change we are all responsible for change to take place not just gps." - V. Henry, North London
"More GPs will obviously help but at a high cost. Bringing down the level of DNAs significantly would provide immediate relief and, for us, would mean 8% increase in use of doctor time. Perhaps a national campaign to educate patients to
'cancel it - don't waste it' if the appointment is no longer required is. What is needed now (at a much lower cost to the DH than more GPs!!!!" - Mike, Derby