A collaboration between Warwick Medical School and Nuffield Department of Primary Care Health Sciences

...access to appointments is THE most pressing issue facing general practice- Pre-grant Public reviewer.

Aim: 

The aim of this study was to describe and compare the long-term outcomes for general practices that have implemented innovations intended to improve access to appointments. For many decades, various approaches have been introduced to support timely access, including online consultation systems, pre-consultation telephone triage, and digital forms completed prior to appointments.

During the COVID-19 pandemic (2020–21), many practices rapidly changed how patients consulted with GPs and practice staff, moving from mostly face-to-face appointments to telephone and video consultations. While some patients and staff welcomed these innovations, others were concerned that certain patients might have been discouraged from seeking help.

Methods:

We began by looking at all the different models of access that have been used, looking at all the published research and talking to doctors, patients, researchers and policymakers. We then worked with eight different general practices in England to learn as much as we could about the different systems they use, how and why they have been adapted locally and what they learnt about their system during the pandemic. We then asked: what happened after practices introduced changes to patient access? Did the systems work or did they need adjustments? Were there safety concerns? Did they change again in the pandemic? We compared these cases with a practice in Copenhagen to see what we might learn for the UK from their experience.