GP Access Report

This Healthwatch Harrow GP Access Report examined patients' experiences of accessing GP services across the London Borough of Harrow between November 2016 and March 2017. The research involved 236 residents, including 143 survey respondents and 93 participants from community focus groups, and was undertaken in response to concerns about GP accessibility raised through Healthwatch's intelligence and feedback systems.

Overall, the report found that patients were generally satisfied with the quality of care provided by GP practices. Most survey respondents rated GP registration processes, reception staff customer care and surgery opening hours as good or excellent. Around 60% of respondents said they were able to see a male or female GP of their choice, and many viewed their GP surgery positively.

Despite this, accessing appointments emerged as the main concern. More than half of survey respondents preferred to book appointments by telephone, but many experienced difficulties getting through to practices, long waiting times on the phone and a need to repeatedly redial busy lines. Patients also reported waiting more than a week to see their preferred GP, while focus group participants often described waiting three to four weeks for appointments with their usual doctor. 

The report found that certain groups experienced particular challenges. People with learning disabilities, mental health conditions, language barriers and mobility difficulties reported greater obstacles when booking appointments and communicating with surgeries. Focus group participants also highlighted concerns about staff attitudes, poor communication and limited awareness of available support services. 

Awareness of alternative healthcare services was mixed. Although many respondents knew about NHS 111, walk-in centres, urgent care centres and pharmacies, only 44% were aware of all four services, and some patients continued to rely on A&E when unable to access GP appointments. Many participants also lacked understanding of how to make a complaint about their GP practice.

The review of GP websites found significant variation in quality and accessibility. While most websites provided basic information and registration details, there was no consistent standard across practices. Information about complaints procedures, urgent care services, walk-in centres, NHS 111, translation services and emergency options was often incomplete, difficult to find or missing entirely. Translation services were not visibly advertised on any GP website reviewed. 

Mystery shopping research found similar inconsistencies. Although most out-of-hours telephone messages included information about surgery opening times and NHS 111, relatively few provided clear information about urgent care centres, walk-in centres or emergency services. The study also found that 68% of practices offered translation services, but availability varied considerably and emergency access could be limited.

Focus groups highlighted concerns about the physical environment of some GP surgeries. Patients frequently reported poor privacy at reception desks, difficulty reading information boards, limited child-friendly facilities and accessibility issues for wheelchair users. Many were unaware of hearing loops, Patient Participation Groups, newsletters or complaints procedures. 

The report also reviewed texting reminder services and found that 74% of Harrow GP practices offered appointment reminder texts, although many patients were unaware of the service. Healthwatch suggested further investigation into whether text reminders reduce missed appointments. 

A review of CQC inspection reports showed variation in practice performance across the borough. Of the 15 surgeries reviewed, one was rated outstanding, ten were rated good, two required improvement and two were rated inadequate. Common themes for improvement included governance, complaints handling, risk management and administrative processes.

The report concluded that there were significant variations in accessibility between GP practices in Harrow and that not all practices were meeting accessible information standards. Healthwatch recommended improving telephone and online appointment systems, increasing support for patients with language needs, learning disabilities and mental health conditions, improving information about complaints and alternative healthcare services, promoting translation services more clearly, and sharing good practice across GP surgeries to provide a more consistent patient experience throughout the borough.