Each entry is matched to one of the checks Tidemark reports on, with the study behind it and a link to the source.
Telephone triage before same-day appointments
Redistributes contacts rather than reducing them.
The ESTEEM trial (42 UK practices) found total clinician time per patient was higher with triage — 10.3 to 14.8 minutes — than standard care at 9.1 minutes, and nurse-led triage increased the number of consultations needed within 28 days.
The most commonly proposed fix for daily-contact overload is the one with trial evidence against it working as intended.
Salisbury C et al. ESTEEM trial, cluster-RCT, 42 UK practices. Br J Gen Pract 2015.
Measuring hidden workload before changing anything
Appointment counts miss most of the working day.
GP Worklife Survey data suggests roughly 40% of a GP's working day is indirect work — results, correspondence, referrals, admin — none of which shows in appointment figures. The authors argue measurement has to come before redesign.
Woolford SJ et al. 'The real work of general practice: understanding our hidden workload.' Br J Gen Pract 2024;74(742):196–197.
Primary care micro-teams
Small, stable clinician-patient groupings instead of a single named GP or a fully open list.
Evaluated across 8 sites in one PCN covering 46,500 patients, before and after.
Saxionis I et al. Is Adopting a Microteams Model a Solution to Delivering Continuity of Care in Modern Primary Care? J Prim Care Community Health 2026
System-level: reduce and reform, not just absorb
The RCGP's own analysis of this exact problem.
Its most practice-relevant recommendation: prioritise continuity-based care models over simplistic appointment-efficiency targets, and reflect indirect work explicitly in how capacity is planned.
RCGP. 'Tackling the GP workload crisis: from evidence to action on hidden and avoidable workload in general practice.' April 2026.