GP access report 2018

Healthwatch Greenwich undertook a comprehensive review of GP access across the borough, combining a public survey of 248 residents, a registration audit of all 42 GP practices, and findings from a programme of GP Enter and View visits. The report found that while many residents were satisfied with their GP services, significant problems remained around appointment access, awareness of alternative services, and consistency in patient registration processes. 

A key finding was the difficulty many patients experienced obtaining GP appointments. While 38.8% of respondents said booking an appointment was easy, 36.2% said it was hard or very hard. Waiting times varied considerably, with some patients receiving same-day appointments while others regularly waited more than three weeks. Respondents reported that delays could worsen health conditions, increase anxiety and sometimes force them to use urgent care services or Accident & Emergency instead. Most people preferred to book appointments by telephone, although there was growing interest in online booking options.

The review found strong public demand for evening and weekend appointments, with over four in five respondents saying they would use them. However, awareness of Greenwich's GP Access Hubs was very low. Nearly two-thirds of respondents had never heard of the hubs, and only around one in five understood what they were and how they worked. By contrast, awareness and satisfaction with NHS 111 were much higher, with most users reporting positive experiences and saying they would use the service again.

The GP registration audit identified ongoing concerns about compliance with NHS England guidance regarding registration without identification or proof of address. Despite previous training, six practices still incorrectly stated that they would refuse registration without documentation, while website information was often inconsistent or misleading. Nineteen GP websites implied that identification or proof of address was mandatory, potentially creating barriers for homeless people, refugees, asylum seekers and other vulnerable groups. Healthwatch also found examples of reception staff giving information that differed from both NHS guidance and their own practice managers' interpretations. 

Across its Enter and View programme, Healthwatch identified recurring themes in GP surgeries, including poor promotion of online services, limited signposting to GP Access Hubs and translation services, long telephone waiting times, confidentiality concerns at reception desks, insufficient information in accessible formats, and a lack of visible patient feedback mechanisms. 

Healthwatch concluded that improving access requires both system-wide and practice-level action. Key recommendations included increasing staff training on patient registration rights, promoting GP Access Hubs more effectively, improving telephone responsiveness, ensuring patients can book non-urgent appointments in advance, strengthening signposting to available services, improving accessibility of information, and ensuring all practices comply fully with NHS England registration guidance.