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Prioritise face to face appointments to improve access, says study

by Beth Gault
11 November 2024

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Initiatives to improve access and satisfaction within general practice should prioritise expanding face to face appointments, a study has suggested.

The research, published as an accepted manuscript in the BJGP, found that patient perception of access relied on more than just availability of appointments and that satisfaction was associated with face-to-face access.

It also found that practices that had a greater proportion of same-day appointments ‘significantly correlated’ with lower patient satisfaction.

The study looked at data from the general practice patient survey and NHS Digital’s appointment data between August 2022 and March 2023 across 5,278 practices.

Its authors, from the University of Manchester, said: ‘The most significant correlation between all the examined measures of patient experience and satisfaction was the proportion of GP face-to-face appointments.

‘If the effects shown in this paper were causal, the effect on patient satisfaction with access caused by increasing the proportion of GP appointments that are face-to-face by 1% is similar to adding 10 additional appointments per 1000 patients per month.’

The authors added that while telephone and IT assisted appointments have an ‘important role to play’, they would ‘cautiously welcome’ an overall increase in face-to-face consultations.

‘Until recently, simply employing more GPs was not seen as feasible. However, given there are now GPs struggling to find work, this may now be a potential option. We would also welcome measures that free up GP time to enable more patient appointments,’ the study said.

The authors said there was a need to study why practices with a greater proportion of same-day appointments have poorer patient satisfaction.

They said: ‘Future NHS plans envisaged an expanded role in primary care for nursing staff and other non-medical health care professionals. There needs to be work to understand why patients are less satisfied and have a poorer experience in practices with higher proportions of non-GP appointments.’

It comes as a recent study suggested that falling GP numbers could lead to a ‘tipping point’ where most general practice appointments are delivered not by a GP but by other practice staff.

It suggested that the number of full-time equivalent (FTE) GPs per 1,000 patients dropped by 15% between 2015 and 2022. Alongside this trend, there has been a shift towards larger practices with a wider breadth of multidisciplinary teams, particularly with the addition of PCNs and the ARRS scheme.

NHS England recently launched a pilot to look at demand and capacity within primary care, with 22 PCNs taking part across seven ICBs. The programme is designed to test whether implementing the long-term workforce plan, along with other digital tools such as process automation, can plug gaps in general practice capacity. 

This article was first published by our sister title Pulse PCN