GP access: an in-depth look at experience and insights

Healthwatch Cornwall researched access to GPs via surveys and its existing feedback.  The report contains the views of over 2,000 people in Cornwall regarding access to general practice. It combines public survey findings with insights from GP staff, patient representatives and local system partners, offering a comprehensive picture of what is working well and where the greatest barriers lie. 

Access to general practice remains a critical concern across Cornwall. While many respondents reported positive interactions with compassionate staff, issues in accessing services persist. Too often, people are left navigating a system that feels complex, inconsistent and inaccessible, particularly for those in rural areas, with additional needs or those who struggle with digital access.

The report highlights that barriers to accessing care are not just about capacity or availability. Structural factors like poor transport links, digital exclusion, poverty and rural isolation continue to prevent many people from even reaching the point of contact. Affordability is a growing concern, particularly for those facing the cost of travel, childcare or time off work. This is compounded by the rising cost of living. Some residents reported having to choose between paying for prescriptions, travelling to their GP or seeking private care, a reality that particularly impacts carers, parents and those on low incomes.

Feedback from both the public and GP staff reflects a system under considerable operational pressure. Practices are experiencing high demand, workforce shortages and increasing complexity in patient needs. These pressures are contributing to long waits for appointments, a lack of continuity with known clinicians and variable experiences across practices. People frequently described difficulty getting through on the phone, frustration with non-clinical triage processes and delays that impacted their wellbeing.

The findings reveal a disconnect between national expectations and local reality. While digital solutions, multidisciplinary teams and access hubs are promoted as innovations, these models do not always work in the Cornish context. Many people described digital-only access routes as exclusionary or difficult to use, particularly older adults and those with additional support needs. A “one-size-fits-all” approach risks widening existing inequalities in access and outcomes.

There is confusion among the public about how general practice now works. People expressed uncertainty about who they would see, how long they might wait and why they were being directed to non-GP staff. While some appreciated the support offered by wider primary care teams, others felt their needs were being deprioritised or dismissed. This mismatch in expectations creates frustration on both sides and highlights the need for better communication, transparency and clarity about what people can expect from their GP practice.

A dedicated section of the report shares case studies of avoidable harm, where people experienced serious delays or were unable to access care at all. Several respondents described missed or late diagnoses, including cases of advanced cancer and preventable hospital admissions. These stories illustrate the realworld impact of access failures and the urgency of getting this right. When people are unable to access timely GP care, the effects ripple through the wider system. Several respondents described delayed diagnoses and reliance on emergency services, failures which increase NHS costs, create avoidable strain on urgent care, and contribute to productivity losses for working carers or parents who miss work while navigating access barriers.

There was clear concern that current models prioritise speed and volume over continuity and relationships. GP staff also acknowledged a growing disconnect between how services are structured and how they are perceived by the public. While digital triage and new roles are being rolled out nationally, these changes haven’t always been well communicated, leading to confusion and dissatisfaction. 

Despite these challenges, there was optimism. Professionals spoke positively about interest in collaborating with patients and their commitment to providing person-centred care. They called for greater flexibility in national policy, more time for continuity with patients and stronger integration across the wider health and care system. Their voices reflect both the challenges and the deep resilience of Cornwall’s primary care workforce.

Despite the challenges, the report also identifies areas of strength and innovation. Many patients praised the care they received once they were seen and GP staff consistently emphasised their commitment to delivering high-quality care under difficult circumstances. There is evidence of collaborative working, a willingness to adapt and examples of good practice that could be shared more widely across the system.