Three quarters of GPs say they don’t have enough time to offer preventative healthcare, according to a Royal College of GPs survey of 2,316 doctors across the UK. With surgeries facing heavy demand and appointments often limited to ten minutes, conversations that might help patients avoid illness are being squeezed out.
That can mean no time to talk properly with someone about stopping smoking, getting more sleep or taking more exercise. It can mean missing the chance to ask whether a patient still needs a medication, or to discuss a vaccination. These aren’t extras that doctors offer when the surgery happens to be quiet. They’re part of caring for people before a problem becomes more serious.
“General practice is dealing with enormous demand, so in a busy consultation we inevitably have to prioritise the problems that most need our attention that day,” said the college’s president, Prof Victoria Tzortziou Brown, a GP in east London.
“We will always act on symptoms or findings that need investigation or treatment. What can be squeezed out is the time to step back and look more holistically at how we can help that patient stay well in the long term.”
The difference between a brief instruction and a useful conversation matters. A GP can tell someone who smokes that stopping would help their health. Finding out whether they want to stop, what’s prevented them before and what support might actually work takes time. As Tzortziou Brown put it: “It is often the depth of those conversations, rather than simply identifying a risk and giving brief advice, that requires time.”
A ten-minute slot puts pressure on both sides of the desk. The doctor has a waiting room full of people and has to deal with the most urgent concern first. The patient may have taken time off work, arranged care for someone else or waited a long time for the appointment. They may have more to say than the clock allows. The RCGP’s findings describe a service in which GPs are still providing preventative care, but often can’t spend the time needed to understand a patient’s circumstances.
Those circumstances are class questions. It’s easy for politicians to talk about healthy choices as though everyone has the same freedom to make them. Sleep looks different when your shifts change from week to week. Finding time to exercise looks different after an exhausting day’s work. Advice about eating well has limits when wages are stretched by rent and bills. None of that makes medical advice useless. It means advice alone can’t remove the conditions that are making people ill.
Capitalism depends on workers’ labour while treating the damage done to their health as someone else’s problem. Employers benefit from keeping labour costs down; workers live with the exhaustion and strain. The NHS is then expected to deal with the consequences, often in a ten-minute appointment. Even within those limits, a GP who has time to listen can make a difference. Three quarters of those surveyed say they’re being denied enough of that time.
The government’s ten-year health plan for England names a move “from sickness to prevention” as one of its major aims. The contradiction is hard to miss. Ministers want GPs to help stop people becoming ill, while GPs say the pressure of treating people who are already ill leaves too little room to do it.
Sarah Woolnough, chief executive of the King’s Fund, said the findings were alarming. She warned that overwhelmed GPs may miss conditions that could have been treated earlier, and said doctors were frustrated at being unable to provide the care they were trained for.
“Talk around shifting from sickness to prevention is meaningless if we cannot get these basics right first,” she said.
The public hasn’t stopped trusting GPs to give this advice. In a separate survey of 2,000 UK voters commissioned by the RCGP, 64 percent said they trusted family doctors for advice on healthy living. That compared with 51 percent for the NHS website, 38 percent for pharmacists and just 7 percent for AI chatbots. The problem identified by doctors isn’t that patients won’t listen. It’s that a proper discussion is difficult to fit into an overloaded surgery.
The RCGP says the NHS needs more GPs and more time for each patient if the government’s prevention plans are to mean anything. The Department of Health and Social Care didn’t comment directly on the survey findings. Instead, it pointed to £1.7bn invested in general practice, the recruitment of 2,000 additional GPs and record numbers of appointments. It also said 77 percent of patients now report having a good local GP service.
Those figures don’t answer what the survey asks. An appointment is counted whether a doctor has time to explore what’s happening in a patient’s life or can only deal with the immediate symptom. More appointments may show how much work GPs are doing, but they don’t show that the work can be done in the depth patients need.
Prevention cannot be reduced to a government slogan or a hurried reminder to sleep more. It depends partly on whether doctors have time to listen, and partly on the conditions people return to when they leave the surgery. GPs are being asked to keep people well in a society that wears many of them down. Three in four say they don’t even have enough time for the conversation.
