People's view on access to GP services in Birmingham

Healthwatch Birmingham undertook a thematic analysis of their feedback about GPs.  Altogether they analysed 2,782 pieced of feedback received during the period April 2021 to January 2022.

People’s feedback indicates varying experiences of access to GP practices. Positive experiences included satisfaction with the use of the triage system, telephone, video and online access as suitable to their needs and convenient for quick diagnoses. However, negative experiences described significant problems with the triage system, and difficulties contacting GP practices or accessing appointments via telephone, online or video.

This has been extremely difficult for certain groups such as the elderly, people for whom English is not their first language, people who are digitally excluded (due to lack of access to a smartphone, laptop/ pc, tablet or digital illiteracy), people with a disability, multiple conditions, sensory impairments, parents and people in work.

The move away from face-to-face GP access to a remote triage system reliant on telephone, video and online consultation has impacted negatively on the majority of patients who provided feedback. his led many to avoid accessing their GP, changing GPs, and accessing other health services (111, A & E). Poor access has left patients in pain, distressed and anxious, and generally losing trust in their GP practice.

The new system has changed the GP-patient relationship, with many patients feeling far removed from their GP practice. One patient likened it to a fortress and expressed concern about lack of continuity. People said that they felt like a ‘nuisance’, not ‘valued’ and ‘not people, just a telephone number’. This has been exacerbated by patients’ difficulties contacting their GP practice over the telephone. Some spent hours on different days trying to get an appointment.

In some cases alternative access routes, (e.g. online, econsult) have been ineffective due to the systems being unfit for purpose, practices not supporting patients to use them, or the practice not engaging with the system (e.g. not responding to online forms). People have shared concerns about the cost of new systems of access, especially if they must spend a long time waiting on the telephone. This has a considerable impact on the elderly and those not in work although some people in work also expressed concern about the long waits on telephones.

Feedback showed a preference for face-to-face contact and consultation. Many people expressed concern that some GP practices hadn’t returned to face-to-face consultations following the Covid-19 pandemic and that digital access excludes some people/groups from accessing GP services. Some also felt that there was potential for poor diagnosis without examining patients in person and doctors often being quick or dismissive over the telephone.

Although feedback about GP access was heard from all areas of Birmingham, Healthwatch Birmingham received more (81%) feedback generally from more deprived areas. People felt that accessing GP services has been an ongoing issue that has worsened with the pandemic. Ensuring everyone has equal access to services is a key priority for the NHS, which calls on local health systems to address inequalities identified by local evidence and take actions to resolve them.