Consultation time, workload, and problems for audit in outpatient clinics.

Fifty four of 74 paediatricians in the West Midlands (43 general medical, 11 subspecialist) replied to a postal questionnaire about their outpatient practice: 37 timed each consultation in one clinic. On average, subspecialty consultations lasted 37 minutes for new patients and 29 minutes for review. In general clinics new patient consultations took 23 minutes, review 12. Mean 'single handed' general clinic size was 18, clinics with assistants 24; subspecialist clinics nine and 15. Four to five new patients and nine to 19 review patients were booked per clinic on average; 17/51 clinics used block booking, 34 provided individual appointment times. Mean referral delay was 4.9 weeks, mean clinic wait 22 minutes, and non-attendance averages 16-29%. Solutions are suggested to four main problems: non-attendance, referral delay, unpunctuality and disorganisation, with audit levels for paediatric outpatient activity.