That members of the public value access to in-person GP appointments sounds like a statement of the obvious. But the findings of an Institute for Government report about general practice in England have more complex implications too. One striking finding is that waits for appointments seem to matter less than is often assumed. Successive governments have pushed for same-day consultations. If this was done to please the public, the research suggests they should not have bothered. Surprisingly, it found no statistically significant relationship between patient satisfaction and length of wait. For many people, there is no substitute for a face-to-face conversation with the family doctor who they may have known for years. A higher number of online and telephone consultations is correlated with lower satisfaction. The shift away from in-person consultations, which accelerated during the pandemic and has not reversed, has coincided with falling confidence in general practice – though the reduction on spending on primary care, relative to hospitals, must also be factored in.
Appointments with other staff do not boost patient satisfaction to anything like the same degree. Once again, this finding raises a question over recent policy, which has been to substantially increase the “direct patient care” workforce, including pharmacists, in England’s 6,200 GP surgeries. The most popular appointments of all are those in smaller practices with higher numbers of GP partners. People’s preferences are not, in themselves, a mandate for change. This study found that practices with higher satisfaction scores also meet more targets. But measuring outcomes in primary care is complicated and previous research has raised doubts about some of the care offered by the smallest practices.
