Primary and urgent care survey - primary care conclusion

There is a clear need to address issues of getting routine and urgent appointments. This is a high priority for patients and the public.

Over 1,600 comments related to this, and they ranged from not being able to get routine appointments, the frustration of the process of trying to get appointments and the need for extended hours especially for those who work. This was for both routine and urgent visits.

Calling first thing in the morning to find out if there is an appointment available is difficult for people who work, caring for children and for some people where drugs make them drowsy in the morning.

A smaller proportion of people also made comments about appointments running late, and needing longer appointment times. 

People showed considerable flexibility in terms of continuity of seeing a GP, and although seeing the same GP was prioritised for long term conditions, many people were happy to see a different GP more quickly for new concerns.  The findings would imply that older people are more likely to value continuity with the same GP, as would those who have physical disabilities, those with long term conditions, and those with mental health problems.  

The survey indicates that visiting a nearby practice is acceptable to many, especially for specialist clinics or avoiding visiting hospitals.  The response to this also varied by age, disability, and having long term conditions.  There were differences in how far people would travel.

Experience of service provision, and comments from the survey suggest that actual patient behaviour may differ from these responses and more granular analysis needs to be made for different areas. 

When looking at seeing GPs in a different local GP practice, again there was relatively high levels of acceptability

Extended hours, and having access to good services out of hours was a key concern for many either through convenience given their working arrangements or anxiety about serious conditions outside of GP hours.  The times that were most popular were evening appointments and Saturdays, with limited interest in Sunday appointments.

There was a strong interest in using IT, especially communicating with surgeries by email, as well as notes being shared across providers. However there is a core group of people who do not use email or online facilities and need face to face or phone contact.

Getting urgent appointments can be a problem for patients, and patients prioritised seeing their own GP at a nearby practice, and having a phone call from a doctor or nurse, followed by dropping in to see a GP.

Triage by trained reception staff was the least popular, but even so two thirds felt that this was moderately acceptable or better.  There was some acceptance of seeing other professionals such as advanced nurse practitioners, paramedics and physician’s associates and pharmacists in an urgent situation.

Respondents made a range of suggestions for improvements in primary care which included:

  • more investment in the health service and recruiting more GPs and staff,
  • other ways to communicate and keep in touch,
  • bringing out of hours contracts back into GP surgeries,
  • improvements in appointment systems,
  • having more local clinics,
  • having more specialist services available in GP surgeries.

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