Scrap GP appointment system, urges health expert

Appointment systems in general practice should be 'abolished altogether' to curb rising dissatisfaction in access to primary care, an influential health expert has suggested.

Waiting room: proposal for GP appointment system overhaul (Photo: JH Lancy)
Waiting room: proposal for GP appointment system overhaul (Photo: JH Lancy)

At a policy debate on the future of general practice hosted by the Nuffield Trust think tank, the speaker argued that an A&E-style drop-in model should be adopted, to give patients more realistic expectations and ensure their waiting experiences are 'as painless as possible'.

Delegates at the event - held under the Chatham House Rule, meaning speakers cannot be identified - spoke of a steady rise in the number of complaints from patients about general practice, which they said were largely driven by difficulties in getting appointments.

Rise in dissatisfaction

‘Looking at data about patient responses to their GP services and patient views on the care they're receiving, there's been a steady rise in dissatisfaction with GP access and it is clearly a growing problem,’ said one delegate.

Once patients had secured an appointment their feedback was much more positive, suggesting tackling appointment times was a key element in improving patient overall satisfaction in GP services.

One influential figure at the event spoke out in favour of adopting a drop-in style model and ‘abolishing’ the appointment system to improve patient satisfaction with GP services.

‘I like the idea that we should abolish appointment systems altogether in general practice,’ the speaker said. ‘It’s a huge area of contention, everybody hates it. Why don’t we do what we do in A&E?’

The speaker went on to praise the simplicity of the A&E system, which means patients can ‘just turn up’ and ‘know they will be seen within four hours maximum, so their expectations are more in line with reality’.

DNA impact would be reduced

The speaker added that triaging patients would mean those with more severe cases are seen sooner, and anyone who failed to turn up would ‘not become a problem for the system’, as as the case with patients who miss a pre-booked appointment.

A drop-in system would give patients ‘good expectation management so that the waiting experience is as painless as possible’, they said, and curtail problems with 10-minute appointments, ‘which inevitably overrun so you have to wait’.

But GPC deputy chairman Dr Richard Vautrey cautioned against a wholesale scrapping of appointments, as it would not suit the needs of patients with many complex long-term conditions.

He said: ‘Many patients reasonably want to plan their care, booking appointments ahead of time to see the doctor of their choice or to attend the surgery at a time that suits them. Sit and wait surgeries could mean very long waits for patients and could potentially overwhelm GPs.’

Workforce issues were the ‘root of the problem’, he said, and solving that issue would improve the problems with the current appointment system.

He said: ‘There are not enough GPs to be able to offer enough appointments to meet the population's needs, and until we increase the number of GPs both patients and the profession will be unhappy with the current situation.’

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