• Samira Nur, James Coultas, Louise Jones, Christine Oesterling, Adrian Tookman, and Steven Walker.
• North West London Training Scheme.
• Br J Gen Pract. 2024 Jun 20; 74 (suppl 1).

BackgroundFrequent attenders (defined as the top 10% of health care users or those making ≥10 visits per year) account for 30-50% of GP consultations. This has significant resource implications.AimTo understand the characteristics of frequent attenders (≥18-years) at an outer London general practice (list 5,876; deprivation index 5th decile) and reasons for attending.MethodA retrospective case note review was conducted using SystmOne of people attending on ≥10 occasions to see a health professional between March 2022 and February 2023. Data were extracted by hand: age, gender, reason and type of consultation, diagnoses, referrals, Charlson Comorbidity Index (CCI), mortality at one year. Patient notes for ≥30 contacts were reviewed by a senior GP.Results544 people (9.3%) attended ≥10 appointments. Of these, five interacted with a GP ≥50 occasions (Group 1;mean age:74.6yrs/female: 4 /CCI:5.0), eight ≥40 occasions (Group 2; 69.6yrs/6.0/5.5) and 35 ≥30 occasions (Group 3;70yrs/27/4.7). Forty-eight people accounted for 882 appointments, 29% face to face and 71% by telephone. Frequency increased with age and CCI. Patients in group 3 underwent more investigations (6.0/6.0/10.0). There was no difference in mean numbers of clinicians seen (6.4/7.1/7.4) or referrals (5.0/4.0/5.0) between the three groups. Frequent attenders tended to fall into two groups: people with chronic diseases, typically associated with anxiety and complex needs, and people with ongoing mental health conditions. Coding was challenging due to complexity.ConclusionFrequent attenders presented due to their medical complexity or mental health disorders rather than medically unexplained symptoms. Most interactions with a GP are understandable.© British Journal of General Practice 2024.

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