Dwindling satisfaction with GP access for patients pre-covid

Most people continue to want to see a clinician within a few days of approaching the service but less than 73 per cent of patients were satisfied with the time of the appointment they were offered — continuing a trend.

The proportion of patients saying they were seen the same day again fell, from 32.6 per cent to 32.4 while those who said they waited more than a week again increased, from 25.3 per cent to 26.4.

Patients were overwhelmingly positive in feedback on their experiences with their clinicians, over 85 per cent of patients saying the clinician they had an appointment with was good at giving enough time to them, listening to them, and treating them with care and concern. However, these measures were also down on previous years

The survey questions were sent out to over 2 million patients between January and March 2020 – receiving nearly 740,000 responses – so it is a snapshot of attitudes just before the covid-19 pandemic forced GPs to dramatically alter access.

Patients now have to go through a digital or telephone triage service before they can book an appointment as GPs, like the rest of the health service, seek to separate covid-19 patients from people without symptoms, and to avoid contact where possible.

Most appointments in primary care before the pandemic were conducted face-to-face, with patient reporting 85 per cent of their appointments were in person and less than 10 per cent over the telephone. Appointments carried out online and over video was a small minority, making up less than 1 per cent.

Operating procedures during the pandemic has broadly reversed this, with the overwhelming majority of appointments now over the phone or through digital services such as text-based online portals for patients to input symptoms and history to be assessed and followed up by a clinician.

The survey represents patient experience during normal running. However, it also includes data on what patients expected from their GPs before the transformation of primary care since March.

GPs and local systems are currently planning how their services will look in the future, with the consensus that a high proportion of patients continuing to access care remotely through the telephone and digital systems will be key. The survey results could indicate what patients will expect again from the service once the current crisis abates, potentially shaping that planning process.

The biggest reason for not taking an appointment continues to be the day or time offered rather than where the appointment takes place, the difficulty of getting to it, or availability of a preferred GP or preferred type of clinician.

GPs are currently offering swifter access to care for their patients, with many remote consultations completed the same day, indicating that although the current covid-mediated changes were forced on patients and practices there could be appetite for making them permanent.

However, patients have stayed away from the health service out of concern they would overload the NHS or they could contract the virus. As patients continue to return to healthcare, there is concern demand could outstrip supply and virtual waiting times could increase.

Nikki Kanani, a GP in London and director of primary care for the NHS, said: “GPs see nearly one million patients every day and it is positive that more than nine in every ten of them have confidence and trust in their family doctor.

“The coronavirus pandemic has radically altered the way patients use primary care services, giving us an opportunity to continue to improve access to high-quality care, including greater use of convenient remote consultations, backed by £4.5bn of added investment by 2023-24.”

Ruth Rankine, director of NHS Confederation’s PCN Network that represents the interests of the primary care networks, said: “As lockdown eases, it will be important for people to be able to access care in a way that meets their individual needs and recognises that for some, remote consultations will not be suitable.

“Working together as part of a PCN, practices will have the opportunity to offer greater flexibility in how people access a wider range of services.”

Update: this post was updated at 14.05 on 9 July to include the quote from Ruth Rankine.