Cancer risk assessment tools on GP consultation workload: a qualitative study

Problem

The UK has a shortage of General Practitioners. There have also been increased consultation rates, consultation durations, and workload. Digital tools assist GPs with screening, diagnosis, and management of conditions. Electronic risk assessment tools (eRATs) have been developed to support GPs in early cancer detection Detecting early cancer is vital in improving patient outcomes. As part of a wider cluster RCT (the ERICA trial) we aimed to qualitatively explore GPs’ experiences of receiving eRAT alerts during consultations and to understand potential impact(s) on workload and workflow.

Approach

Eighteen GPs were interviewed between February and April 2023 across 16 practices participating in the intervention arm of the ERICA trial . Interviews were transcribed and analysed in NVivo14 using thematic content analysis.

Findings

Four themes were identified: existing workload/time pressures, the reality of using eRATs, GPs’ emotions regarding workload, time, and workflow disruption, and the need to strike a balance between consultation duration and other potential competing factors such as the importance of diagnosing cancer, cancer risk level , and patient characteristics.

Consequences

This study confirmed the common expectation that tools like eRATs will add workload or time to consultations or disrupt workflow. Our findings also indicated that existing pressures , which GPs often expressed in terms of war or battle context, GPs’ experience level, GPs’ emotions, and patient characteristics, all affect whether eRAT alerts were attended to. The findings can inform future implementation of eRATs and support provided to GPs.