One in seven people in England can’t get GP appointment within two days, survey shows

BMJ 2008; 337 doi: (Published 01 August 2008) Cite this as: BMJ 2008;337:a1117
  1. Roger Dobson
  1. 1Abergavenny

    Nearly one in seven people in England cannot get an appointment with a GP within the current target of two working days, although most are satisfied with their care when they do get a consultation, a new survey has found.

    The national survey of 69 000 people by the Healthcare Commission also showed that a quarter were unable to book an appointment three or more days in advance and that there were wide geographical variations in this proportion.

    More patients than in previous such surveys are completely satisfied with the care they get in general practices and health centres, with high proportions saying that they are treated with dignity and listened to carefully. But the survey also shows that patients continue to have concerns about practices’ opening hours, difficulties in booking appointments in advance, and problems in contacting practices by telephone.

    “People clearly do want to be able to see a GP more easily and at more convenient times,” said Anna Walker, the commission’s chief executive. “It was striking that some people could not get an appointment within two days and that there are variations around the country.

    “It is clear that more people want to be able to book appointments several days ahead and that many want more flexible opening hours. In addition, a significant proportion of patients are not being offered a choice of hospital. These are issues that a modern 21st century health service really ought to be able to address.”

    The survey, which was carried out between January and April this year, asked people about their experiences of general practices and health centres and also dentists.

    The results showed that patients rated doctors’ personal skills highly, with 93% saying that they were treated with respect and dignity, an increase from 92% in 2005. Three quarters (74%) said that they definitely had trust and confidence in their doctor.

    But 13% of patients had to wait longer than the 48 hour target time because no earlier appointment was available. In the best performing trust 89% of patients taking part in the survey were seen by a GP within two working days, whereas in the worst trust this figure was 43%.

    Patients should be able to book a routine appointment with a doctor three or more working days in advance, and the survey shows that the number of trusts able to do this rose from 70% in 2005 to 74%, with the figure ranging across trusts from 48% to 93%.

    Overall, 25% of people had, at some time, been put off going to their general practice or health centre because the opening times were inconvenient for them, up from 21% in 2005. Other results show that 55% of patients always or sometimes had a problem getting through on the phone to their GP practice.

    Patients being referred for a first outpatient appointment should be offered a choice of hospital, and the survey shows that nationally, 43% of those referred said they were offered a choice, nearly double the 2005 figure of 26%.

    On dental care, the survey found that 76% of those who regularly visit a dentist privately would like to receive NHS dental care, as did 81% who had not seen a dentist for two years.

    David Stout, director of the Primary Care Trust Network, which represents most primary care trusts, said, “In the parts of the country where patients find it more difficult to get a GP appointment, trusts will continue working hard to find local solutions to widen access, and the introduction of new health centres and extending opening [hours] will help improve access and patient choice.”

    Richard Vautrey, deputy chairman of the BMA’s General Practitioners Committee, said that it was good to see that, overall, patients were very satisfied with the service they had.

    “With a limited number of appointments in any one day, practices try very hard to strike a balance between making sure that patients who want to book ahead are able to do so while still ensuring there are enough empty appointments for emergencies,” he said.

    “On the whole it seems GP surgeries are getting it right. However, there are variations with access across the country and we want all patients to receive a good service from their GP. Whatever their current rating, all practices, with the support of their local health trust, will want to further improve the service they provide to their patients.”

    For the first time the Healthcare Commission has published comparative scores for all primary care trusts in England on its website.


    Cite this as: BMJ 2008;337:a1117


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