What experience has shown us

A systems approach to embedding group consultations in the NHS

Article in the Future Healthcare Journal 2019 Vol 6, No 1: 1–9 by Tania Jones , A,B Ara Darzi , C Garry Egger , D Jeannette Ickovics , E,F Ed Noffsinger , G Kamalini Ramdas , H John Stevens , I Marianne Sumego J and Fraser Birrell.



“Group consultations are an important care option that is starting to gain traction in the USA and Australia. This review summarises the likely benefits accruing from a systems approach to implementing group consultations widely in the NHS and other socialised healthcare systems. Existing evidence is mapped to five distinct systems approaches: (1) development; (2) different age groups; (3) patient-centred pathway of care; (4) NHS system changes; and, (5) education. Implications are discussed for patients and staff, who both benefit from group consultations once embedded; ranging from improved access and efficiency to more enjoyable multidisciplinary team working, improved resource management, and maintained/better outcomes. Moreover, even patients who don’t attend group consultations can benefit from system effects of long-term implementation. Changing behaviour and health systems is challenging, but change requires systematic experimentation and documentation of evidence. We conclude that group consultations have unique potential for delivering system-wide benefits across the NHS.”

Group Consultations: Evidence & Case Study Overview

Current and emerging evidence and case studies for Group Consultations, across the following speciality areas:

  • Dermatology
  • Rheumatology
  • Gastroenterology
  • Gynaecology
  • Gynaecology
  • Diabetes/
    Primary Care
  • Cardiology
  • Trauma and Orthopaedics
  • Hypertension
  • Urology
  • Other

Group Consultations – Frequently Asked Questions

  • Why are we doing group consultations?

  • What are Group Consultations?

  •  How do Group Consultations work?
  • Is there any evidence group consultations work?

  • Why do we need training and coaching to run group consultations?

  • Common Mistakes

  • How widely can I apply group consultations?

  • What Group Consultations are and what they not?

  • What are the potential efficiency gains?

  • What problems do group consultations solve?

  • What kinds of people can I include in my group consultations?

  • Are group consultations the way forward?

Croydon CCG independent evaluation of group consultations

  • High patient acceptability
  • Major improvement in all aspects of patients’ self-management
  • Major improvements in clinical outcomes (Type 2 diabetic patients)
  • High staff acceptability, particularly amongst GPs

The evidence for the effectiveness, appropriateness and feasibility of group clinics for patients with chronic conditions.

A systematic review of evidence from randomised control trials – by Andrew Both et al  – School for Health Related Research (ScHARR), University of Sheffield.

Group Consultations – Croydon Case Study

General Practice adult diabetes care.

Group clinics for young adults with diabetes in an ethnically diverse, socioeconomically deprived setting (TOGETHER study)

Read about the protocol for a realist review, co-design and mixed methods, participatory evaluation of a new care model.

Source: BMJ Journals

Shared Medical Appointments in the UK

Read Dr Rob Lawson’s article from the RCGP Website