A range of factors contribute to whether patients feel they have good access to general practice care, including practice location, opening times, ease of arranging appointments, and speed of access.
Performance by access criteria is now part of the quality-monitoring system for general practice. But patients still complain of trade-offs, for instance between speed of access and seeing the practitioner of choice.
Related document: A rapid view of access to care
What did we explore?
To inform its work, the Inquiry panel commissioned a research project to describe what good-quality access to GP care looks like, and how it can best be measured. A rapid view of access to care provides a framework for assessing access, and looks at the implications for future general practice provision. The paper's authors are Seán Boyle, an independent health planning and policy consultant; John Appleby, Chief Economist, Health Policy, The King's Fund; and Tony Harrison, Fellow, Health Policy, The King's Fund.
What have we learnt about access to GP care?
In March 2010 the Inquiry held a seminar on access to care with participants including GPs, practice nurses, NHS executives, health academics and patient representatives.
Key issues raised in discussion include:
- Should the '8am phone lottery' have become the established (and accepted) route into same-day care?
- Is improved access inevitably in tension with quality of clinical care and continuity of care?
- How can an access system best balance a patient’s objective and subjective need to see a GP?
What's your view?
During the inquiry, we asked for your opinions on this care dimension. You can read comments submitted below.
There are some potential tensions between the proposed national commissioning board's role as commissioner of primary care and local work by the proposed health and wellbeing boards, together with the roles of local planning authorities (predominantly district and borough councils). There needs to be more of a joining up of approaches where significant population change as a result of spatial planning places more pressure on primary care services.
Will the national commissioning board take a lead on workforce planning for GPs as well?
In my opinion what is needed is better education of patients regarding appropriate use of the GP and a debate about the level of access which provides safety for patients and is affordable. The top-down target of 48 hours fails completely in every respect.