Resident doctors across the NHS are spending four times more on paperwork than with patients, a new national study has revealed.
The research – called the TACT Study and carried out by scientists at Imperial College, London – is the first of its kind in the UK. It shows doctors in training spend just 18% of their time with patients and over 70% doing administrative work such as writing notes, chasing test results, and filling out discharge letters.
The study comes just days after the government launched its new 10-year plan to ‘fix’ the NHS – including more community care, digital upgrades and a focus on prevention rather than treatment.
But the new research suggests the biggest problem is being sidelined: doctors are drowning in administration.
A team of doctors and researchers led by Dr. Sammy Arab and Mr. Karanjot Chhatwal from Imperial College London and the National Heart and Lung Institute tracked 137 junior doctors in NHS hospitals over seven months between January and July 2024. Using stopwatches they precisely recorded how each minute of a four-hour work period was spent in real-time across multiple NHS hospitals in England. The doctors were in training posts ranging from Foundation Year 1 to Specialty Training Year 8.
Tasks were grouped into five categories: History taking and examinations, procedural, discussions with the multidisciplinary team, administrative tasks, and breaks or teaching.
They discovered:
Only 1 hour in 6 was spent with patients.
4 out of 6 hours were spent on administrative tasks.
Doctors earlier in their career had less patient contact than senior ones.
Women doctors spent more time on paperwork than men.
Doctors using electronic systems spent even more time on administrative tasks than those using paper notes.
Experts say doctors need real experience with patients to learn how to diagnose and treat illness. But the report suggests they often don’t get enough time.
Dr. Sammy Arab said: “The heart of medicine is human connection. By reducing administrative overload, we can bring doctors back to the bedside, where they’re needed most.”
Mr. Karanjot Chhatwal said: “We hope researchers, policymakers, and frontline teams use this data as a springboard, to drive positive change and to ensure the next generation of doctors can thrive.”
“Every extra minute we give doctors with their patients is an investment in healing”
After each observation, doctors were asked to complete a satisfaction survey. Of those who responded:
62% reported moderate or high dissatisfaction with the amount of administrative work.
Tasks most preferred by doctors were patient-related; admin tasks were least preferred.
The paper states: “Excessive non-clinical duties for resident doctors can result in poorer health outcomes and diminished patient satisfaction.”
The researchers said time taken on administration could lead to delays, miscommunication, and mistakes. And they say this paperwork overload is one of the main reasons they’re burning out and threatening to leave.
The study soon to be published in QJM (formerly the Quarterly Journal of Medicine) and published by Oxford University Press recommends urgent solutions:
Give more admin tasks to trained assistants, not doctors.
Use better computer systems – they say the current ones are slow and clunky.
Let senior doctors spend more time mentoring younger ones.
Set up a national NHS computer system, not different ones for every hospital.
Researchers say other countries have made these changes and seen big improvements. In Japan, cutting admin saved doctors time and boosted care.
Govt quote to come
A Department of Health and Social Care spokesperson said: “Through our 10 Year Health Plan, we’re slashing bureaucracy across the health service, reducing burdensome administrative tasks and making use of technology so doctors can spend time on what they do best – caring for patients. This includes rolling out AI scribes to end the need for clinical notetaking, letter drafting, and manual data entry so clinicians can focus on treating patients, saving the same time as adding 2,000 more doctors into general practice.
“We have also already reduced the amount of repetitive mandatory training resident doctors are required to do and alongside delivering the second above inflation pay increase in a row this year, we have been listening to doctors to make their working lives better. There’s more to do, but the NHS has been making good progress on small changes which have an outsize impact.”