Revealed: One in seven callers could not reach GP in worst-performing ICS

The survey figures, collected for the first time by the Office for National Statistics, show 8.5 per cent of people nationally who tried to call their GP between mid-January and mid-February this year said they could not reach the practice. This equates to 1.5 million people across England, according to the ONS.

In Northamptonshire – the worst performing ICS – 14.7 per cent of callers did not manage to make contact (see map - Patient experience of GP access varies significantly between ICBs). That is the equivalent of around one in seven people. By comparison, only 3.9 per cent of callers in Gloucestershire, the best performing ICS, could not get through. The findings are broadly similar when population and age are accounted for (see second dropdown map). 

The data is from the first edition of the GP Access Survey, based on a sample of 89,000. It had more respondents and is more granular than previous ONS GP access  surveys, meaning it gives results at ICS level and other demographics. It is, however, much smaller than NHSE’s GP Patient Survey  – but this only runs once a year, with a long lag-time, and is not so focused on access problems.

The ONS said NHSE will use the findings to “help understand differences in the experiences of access to GP care and waiting for NHS treatment between demographic groups and by [ICB]”. 

Kent and Medway –  the second lowest performing system, where 13.4 per cent of patients could not get through to their GP practice – told HSJ  all but one of its surgeries were now using advanced phone services as recommended in the national primary care recovery plan, with the final surgery due to switch next month. 

However, the integrated care board acknowledged “too many patients still find it difficult to contact their practice”, adding it will work with practices to help manage demand.

Some of the findings disagree with other access measures, such as GP Patient Survey results, and how quickly appointments take place after booking. For example, North Central London – the third lowest performing – said its practices offered an average of 51 per cent of appointments on the same day, higher than the national average of 43 per cent.

It added it will “be able to see where practices may need support to handle incoming call volumes and to meet demand” when call data is released from digital phone systems from October.

Sussex – the fourth lowest performing ICB – acknowledged “some patients may have difficulty getting through to their practice on the phone” during “busy periods” but added: “Almost all practices have now implemented a new cloud-based phone system.”

HSJ  contacted other low-performing ICBs for comment.

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Meanwhile, 72.5 per cent of callers nationally said they got through on the same day, but nearly a fifth had to wait a day or more to reach their GP. 

In addition, the survey found 12.7 per cent of callers said they had to wait more than two weeks for an appointment (see chart below). A further 6.4 per cent were told to make contact another day or contact 111, which could be due to limited capacity or other reasons such as a patient’s GP preference. 

In last spring’s primary care recovery plan, the government and NHSE said patients should know on the day they contact their practice how their request will be managed and should no longer be asked to call back on another day to book an appointment. It also said clinically urgent needs should also be assessed on the same day, while non-urgent appointments should be scheduled within two weeks. 

In an update to the recovery plan on Tuesday, NHSE said it will share data from digital phone systems on the number of calls to 111 in core hours; so practices only divert to 111 in “exceptional circumstances” and should inform their ICB if they do so. 

It said the vast majority of practices have signed up to the digital phone systems, which it says will mean callers can be redirected or receive callbacks rather than hit engaged tones or waits in long queues. NHSE expects 99 per cent to be live by May. 

More than 90 per cent of practices now allow patients to use the NHS App, which could mean they can access records, repeat prescriptions, manage appointments, and messaging, it added. 

There is no nationally approved way of measuring primary care demand. However, the 2024-25 planning guidance  said ICBs should establish a “full understanding of demand and capacity” in primary care. It does not give detail on how, but NHSE plans to collect digital call data from GP practices from October, as part of the 2024-25 GP contract.

The latest national data on GP appointments shows practices are delivering more appointments than before the pandemic, with 30.5 million in February 2024 compared to 24.7 million in February 2020.