Short or long consultations? Primary care nurses' considerations in making appointments with general practitioners

In Sweden primary care nurses (PCNs) at the health centres (HCs) manage the appointment systems and decide the appointed length of general practice consultation time. This study aims at elucidating experienced PCNs' considerations in booking consultations of different lengths. The grounds for giving long or short appointments were searched for. Qualitative methods were used and 10 PCNs at eight HCs in Umeå Health District in northern Sweden were interviewed. The PCNs take factors from two areas into consideration; one area, often immediately apparent, concerns immediate and straightforward issues such as the patient's reported problem, the patient her/himself, the doctor her/himself and the current situation at the HC and in the catchment area. The other area for consideration usually develops through experience over the years and concerns time consumption in a longer perspective. The overall quality of the consultations is then in focus and the length of a separate consultation is of minor interest. The PCNs do not applicate a straightforward relation between length of time and quality of consultations. Experienced PCNs seem to promote accessibility of primary care and their efforts in allocating time in a practical way probably increase the quality of general practice consultation.