Practice managers bear the brunt of abuse given out by patients who feel they can’t access their GP, a new landmark report shows.
And Government efforts to improve access to GPs are failing – with findings showing that instead patients are facing worse care, growing inequalities, and exhausted staff.
The white paper, Access All Areas: What general practice staff think about the focus on access in primary care policy, by Cogora, the publisher of Management in Practice, was based on a survey of more than 2,000 GP staff, over 100 interviews, and analysis of NHS Digital and GP Patient Survey data.
It revealed that nearly three quarter of practice managers (71%) say they ‘have faced verbal abuse from staff due to access issues. This compares with 55% of all practice staff. in addition, 63% of practice managers have been on the receiving end of online abuse compared with 26% of other staff.
When it comes to physical abuse, around one in six practices said it was a problem.
One practice manager told researchers: ‘Our receptionists face shouting and swearing almost daily – it’s demoralising when they’re doing their best.’
And a GP in Cornwall admitted: ‘I’m sworn at multiple times a day. It’s pushing me towards private work – I may leave the NHS altogether.’
The report, being launched in partnership with campaign group Rebuild General Practice at a Labour Party Conference fringe event today, goes on to highlight that 70% of practice staff say complaints about access have increased since Covid, with nearly a third (31%) of complaints related to this issue.
This is despite GPs providing more appointments per day than ever – 231 per 10,000 patients, 2025 data shows. Pre-Covid, this stood at 206 appointments per 10,000 patients.
The report also found:
- Nearly half of GP staff (46%) say continuity of care is the biggest priority for patients – yet Government policies on extended hours, pharmacy schemes and expanding non-GP roles are undermining it. For example, with extended hours first introduced in 2013, the report highlighted that numerous studies looking at its impact on patient satisfaction found no ‘linear association’ between extended hours and patient experience.
- 14% of practices said they would have to cut their list size by more than a fifth to provide the access they would like based on their current resources. However, 40% said they are at the right size to provide a level of access they are happy with and 18% even said they could increase their list size and still provide good patient access.
- Practices in deprived and ethnically diverse areas consistently deliver worse patient access, due to outdated funding formulas that fail to account for deprivation.
A series of eight recommendations have been put forward by the report, including that: fragmented funding should be consolidated into simple capitation payments with staff costs ring fenced; all surgeries – including small ones – should be provided with funding to ensure premises are fit for purpose; the Carr Hill funding formula should be reformed to take into account challenges faced by practices in deprived areas; and new multi-neighbourhood contracts that include general practice services should have primary care staff at their helm and not be allowed to be run by hospital trusts.
Report author and editor-in-chief of Pulse Jaimie Kaffash said: ‘Patients don’t want fragmented, rushed care – they want a GP who knows them and has time to care. Our research shows high-performing practices succeed by focusing on continuity and quality, not appointment targets. If Government is serious about improving access, it must stop reducing general practice to a numbers game.’
You can find all the data and the methodology in the full report, which can be downloaded here.
Commercial partner of this white paper: General Practice Solutions
Further articles based on the report findings will be published over the next few weeks.
