Researchers consider roll-out of ‘standing’ GP appointments

A familiar sight at a GP surgery Credit: Anthony Devlin/PA

“Please take a seat” may stop being the greeting of choice at GP surgeries, as a study will look at whether standing appointments should be rolled out across the NHS.

Loughborough University is leading the experimental study which will see family doctors given convertible standing desks and wear activity trackers to monitor their movements.

It is hoped that the standing appointments will make GPs an example of good practice for patients, prompt conversations about the risks of being sedentary and help both patient and doctor become more active.

Another possibility may be that standing could shorten the average consultation time.

Researchers have consulted with the Royal College of GPs (RCGPs), which said it is looking forward to seeing the results.

Amanda Daley, professor of behavioural medicine at the university, said the standing appointments will be for adults only and that patients will be able to sit if they wish.

She told the PA news agency: “Historically, GPs and patients sit during consultations to facilitate good doctor-patient rapport – we have all heard the familiar greeting from our GPs to ‘take a seat’.

“But we also know that GPs spend a long time sitting down during the working day – which can contribute to poor health outcomes – and evidence suggests that doctors often neglect their own health.

“Therefore, we need to find ways of getting GPs on their feet and moving more often. Standing consultations could help GPs to be more active, as well as highlighting to patients the importance of reducing and breaking up their sitting time.”

She added: “We want the GPs to be standing in their job … but obviously the extra bit is also being a role model to getting the patients to be more active, or certainly standing more.

“So we are hoping we get a double win.”

Researchers will ask around 500 GPs across the UK their views around introducing standing consultations in the new year.

In spring, a group of GPs in the Midlands will wear ActivPAL activity trackers on their thighs to provide objective data about their movements during and after the working day.

They will be given the desks to use in 30-40 half-day sessions over four to six weeks.

GPs will be asked about their wellbeing, productivity at work and activity level before and after they have used the desks.

Patients will also be quizzed when they leave their consultations.

The desks, which cost around £2,000, can switch between standing and seated formats in seconds with the push of a button.

GPs will be able to use their discretion as to whether they stay standing for the appointment.

For patients who are elderly, frail, pregnant, disabled or about to receive bad news, it may be more appropriate to be seated.

Prof Daley added: “If you come in for a repeat prescription there’s no reason to sit, sitting just takes up more time, so it might be that for certain types of consultation it makes things quicker, and for others it’s just not appropriate.

“For example, if someone comes in for bad news or a cancer diagnosis, you might just want to sit.”

The RCGPs said some NHS workplaces are already switching to “standing meetings” as a way of reducing sedentary behaviour.

Helen Stokes-Lampard, RCGPs chairwoman, said: “Standing consultations could be an effective way of having productive and beneficial conversations with some of our patients, particularly around ‘lifestyle’ issues and highlighting the need for us all to reduce our sitting time and move more.

“However, we need to be mindful that the GP-patient consultation relies on high quality, face to face, communication and in some cases, this will not be achieved if the GP is standing while their patient is sitting down.

“There might be cases where it is appropriate for the GP and patient to carry out the consultation while they are both standing up, but for many of our patients who have complex needs or mobility problems, this will not be an option, and indeed some GPs will not be physically able to participate in this way.

“It is also important that our patients are never made to feel uncomfortable as a consequence of this or any other well-meaning initiative.”