GP practice data available for first time

Appointments in General Practice, October 2022 | NHS Digital

Patients will be able to make more informed choices on the GP practice they choose to visit after data showing detailed appointment waiting times was published for the first time. The statistics, which cover all GP practices across England, is being made available to inform patients how many appointments each practice is delivering and on the length of time taken from booking an appointment to the appointment itself.

Key Facts:

• 36.1 million appointments were estimated to have happened in October 2022, of which 4 million were Covid vaccinations delivered by a practice/PCN.
• 38.9% of appointments in October 2022 took place on the same day that they were booked.
• 43.5% of all appointments in October 2022 were carried out by a GP and 23.7% were carried out by nurses.
• 71.3% of all appointments in October 2022 were carried out face to face.

Further detail: Appointments in General Practice, October 2022

Press release: GP practice data available for first time

Problems accessing appointments are seen as the biggest challenges facing general practice

In general practice, booking appointments and long waiting times are perceived by the public as the biggest challenges. This survey also found increased concern about not being able to see the same GP or other health professional, and not being able to get an appointment in the right format or time | Public perceptions of health and social care: what the new government should know | The Health Foundation | IPSOS

This report highlights findings from the second survey in The Health Foundation’s programme of public perceptions research, delivered in partnership with Ipsos. 2,068 people aged 16 years and older in the UK took part in the survey.

The report notes that General practice is affected by substantial staffing shortages and public satisfaction is at an all-time low. Government made a manifesto commitment to create an extra 50 million GP appointments a year and general practice is delivering record appointment numbers. But people’s experience of accessing general practice is worsening.

Although fewer people see long waits for an appointment as a challenge for general practice compared to 6 months ago (40% compared with 46%), it is still seen as the second biggest challenge after ‘difficulties booking appointments’ (43%). Other issues in general practice have since become more pressing. There have been significant increases in people who think the biggest challenges are not being able to see the same doctor or health care professional each time (28%, up from 19%), not getting an appointment in a suitable format (26%, up from 22%) and not being able to get an appointment at a suitable time (17%, up from 11%).

Other main points:

• The public is pessimistic about the state of the NHS. The majority (55%) think the general standard of care has got worse in the past 12 months. The public supports a mix of measures to fix NHS staffing issues, even if they mean extra public spending. 
• The public is also pessimistic about adult social care, although less so than in November 2021. The majority (56%) think standards have got worse over the past 12 months. Looking ahead, 43% think standards will deteriorate further. Only 15% of the public thinks social care services in their local area are good. 
• The public wants a better health service, not a departure from the NHS model. 77% believe, ‘The NHS is crucial to British society and we must do everything to maintain it.’ And they back additional spending to support it: 71% think greater government investment in the NHS is necessary over and above new funds raised through the health and care levy. 
• The public is also deeply concerned about the impacts of rising costs of living on the nation’s health. 57% think rising living costs are a high or very high threat to the health of UK citizens. 72% believe overall health and wellbeing has declined in the past 12 months.

Full report: Public perceptions of health and social care: what the new government should know | The Health Foundation

See also: Fix workforce crisis and fund health service properly – public send clear message to government to back the NHS

Getting the best out of remote consulting in general practice

via Nuffield Trust

The Covid-19 pandemic triggered a very sudden and widespread shift to remote consulting in general practice. While many patients and clinicians have welcomed the convenience, quality and safety of remote consulting, inherent tensions still exist in choosing between remote and face-to-face care when capacity is constrained. This new Nuffield Trust report explores the opportunities, challenges and risks associated with this technological shift, and the practical and policy implications of recent learning.

The report also sets out a new framework for planning and evaluating remote consultations, and provides recommendations for policy makers, service planners and frontline staff on how to get the best out of remote consulting in the future.

Full detail: Getting the best out of remote consulting in general practice – practical challenges and policy opportunities

Summary: Getting the best out of remote consulting in general practice – practical challenges and policy opportunities

Appointments in General Practice, April 2022

The aim of the publication is to inform users about activity and usage of GP appointments historically and how primary care is impacted by seasonal pressures, such as winter | via NHS Digital

NHS Digital publishes this information to support winter preparedness and provide information about some activity within primary care. The publication covers historic appointments, marked as attended or did not attend, from national to CCG coverage. The aim is to inform users, who range from a healthcare professional to an inquiring citizen, about appointments within primary care.

Key facts:

• 25.3 million appointments were estimated to have happened in April, of which 1.3 million were Covid vaccinations delivered by a practice / PCN
• 45.2% of appointments in April took place on the same day that they were booked
• 91.8% of all appointments were attended in April
• 48.8% of all appointments in April were carried out by a GP and 20.7% were carried out by nurses

Full detail: Appointments in General Practice, April 2022

See also: GP teams still working to their absolute limit, shows latest consultation data | Royal College of General Practitioners

General practice on the brink: how did it get there?

General practice is on the brink, and policy-makers, clinicians and patients seem to know it. But how did it come to this? At the start of a mini series of blogs on general practice, this article reflects on how its problems came about and what lessons can be learnt from them | Nuffield Trust

The article explains how a combination of increased demand, staff burnout and deteriorating patient experience are threatening the stability of general practice.

Sitting at the heart of low public satisfaction with the NHS – now at a miserly 36% according to the recently published British Social Attitudes survey, the lowest level recorded in 25 years – is frustration with access to GP appointments. Two-thirds of people who were dissatisfied with the NHS said that this was due to waiting times for a GP or hospital appointment.

Full detail: General practice on the brink: how did it get there?

Also within this series from Nuffield Trust::

• General practice on the brink: what should reform look like? 
• General practice on the brink: what’s needed to implement change? 
• General practice: case studies of GP organisations working at scale to deliver access and continuity

GP must be physically present at all times during PCN enhanced access hours

A GP must be physically present at all times during PCN weekday evening and Saturday enhanced access appointments, NHS England has confirmed | via PULSE

Earlier this month, the BMA GP Committee advised that a GP must be ‘available’, but not necessarily ‘physically’ present during enhanced access shifts offered by PCNs under the new DES. This was based on ambiguity in the wording of the contract document. However, NHS England has now said that a GP is required to be physically present at all times.

An NHS England spokesperson told Pulse: ‘From October, all primary care networks will be required to ensure a GP is available to see patients face-to-face on Saturdays between 9am and 5pm, as is already the case in many parts of the country.’ They confirmed on background that this means a GP must be physically present at one GP practice within a PCN area throughout the whole enhanced access service period – 9am-5pm on Saturdays and 6.30pm-8pm on weekdays.

Full story: NHSE: GP must be physically present at all times during PCN enhanced access hours

Appointments in General Practice

via NHS Digital

Appointments in General Practice, March 2022 is the latest publication in a monthly series containing experimental statistics about activity and usage of GP appointments. It includes information such as the number of appointments, the number which were attended or not and the time between booking and appointment date.

The report also contains three new measures:

• Figures on the duration of consultations, in minutes.
• Further detail on the context of the activity, such as whether it was an appointment involving the patient directly or clinical activities on behalf of the patient. There is also a further breakdown into the category of the activity, such as routine general consultation, planned clinic or home visit
• More detail on the healthcare professional leading appointments, broken down to roles including GPs, nurses and staff providing other direct patient care.

Full report: Appointments in General Practice, March 2022

Access to and delivery of general practice services

New analysis by the Improvement Analytics Unit (IAU) finds that 10% of patient care requests made to GP practices indicate a preference for a face-to-face consultation | via The Health Foundation

The analysis examined data from 146 GP practices in England using the askmyGP online consultation system between 1 March 2019 and 30 September 2021, including over 7.5 million patient-initiated requests for care. Use of the online system allowed analysts to follow patients’ journeys from the initial point of contact through to delivery of their care. This information was examined alongside data captured on patient characteristics, clinical needs and preferences.

It found only a minority of patient requests for care stated a preference for a face-to-face consultation – falling from 30% of requests before the pandemic to less than 4% at the start of the pandemic. And while requests for face-to-face consultations did increase after that, they only accounted for 10% of requests by the end of the study period in September 2021.

Telephone consultation was the most popular patient preference, favoured on average in 44% of requests pre-pandemic, and by 55% of patients in both 2020 and 2021. Requests for a response via SMS/online messaging accounted for on average 26% requests pre-pandemic, rising to over a third in 2020 and 2021. Fewer than 1% of patient requests asked for a video consultation.

Full analysis: Access to and delivery of general practice services. A study of patients at practices using digital and online tools

Press release: Analysis finds 10% of patient care requests indicate a preference for face-to-face GP consultation

Patients’ preferences for telemedicine versus in-clinic consultation in primary care during the COVID-19 pandemic

BMC Primary. Care 23, 33 (2022). https://doi.org/10.1186/s12875-022-01640-y

The Hybrid Patient Care system integrates telehealth and in-clinic consultation. While COVID-19 increased telehealth use, healthcare providers are still seeking the best combination of virtual and in-clinic consultation. Understanding patients’ tele-consultation-related preferences is vital for achieving optimal implementation. The discrete choice experiment (DCE) is the stated preference technique for eliciting individual preferences and is increasingly being used in health-related applications.

The study purpose was to evaluate attributes and levels of the DCE regarding patients’ preferences for telemedicine versus traditional, in-clinic consultation in primary care during the COVID-19 pandemic, in order to facilitate successful implementation.

Mozes, I., Mossinson, D., Schilder, H. et al. Patients’ preferences for telemedicine versus in-clinic consultation in primary care during the COVID-19 pandemic

General practice access routes campaign resources

General practice access routes | Public Health England

There are different ways that a patient can request help from a general practice. They can phone or visit the practice, but they can also go to the practice’s website and complete a convenient and secure form.

Familiarity with requesting help via a practice website is limited and even patients who are aware may use it reluctantly. Many may think that by requesting help via the website, they won’t get what they need – a face-to-face appointment, for example.

Furthermore, many patients don’t realise that regardless of how they contact their surgery – whether by phone, in person or using an online form – their practice will help them get the care they need, whether it’s a face-to-face appointment, a phone or video call or by sending a text or online message.

The General Practice Access Routes campaign helps patients to better understand the choice of access route they can use when contacting their surgery and how their practice will respond.

A toolkit and materials are available to help practices communicate with patients about the best ways of getting in touch with them when they need help, and explains how the practice will manage the request and contact the patient in response.

Full detail: General Practice Access Routes