Booking a GP appointment is a routine task, yet for many people it's a source of frustration. Long waits, confusing systems and impersonal processes have become all too familiar. While much attention has been paid to how difficult it is to get an appointment, less research has asked a more fundamental question: what do patients actually want from their general practice?
Author
- Helen Atherton
Professor of Primary Care Research, University of Southampton
To answer this, my colleagues and I reviewed 33 studies that were a mixture of study designs, and focused on patients' expectations and preferences regarding access to their GP in England and Scotland.
What people wanted was not complicated or cutting edge. People were looking for connection; a friendly receptionist and good communication from the practice about how they could expect to make an appointment. And they wanted a general practice in their own neighbourhood with clean, calm waiting rooms. So far, so simple.
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People wanted booking systems that were simple and user-friendly, without long automated phone menus ("press one for reception"). Preferences varied. Some patients valued the option to book appointments in person at the reception desk, while others preferred the convenience of online booking.
Regardless of how they booked, patients wanted shorter waiting times or, at least, clear information about when they could expect an appointment or a callback.
Ideally, general practice would be open on Saturdays and Sundays for those who cannot attend during the week.
Remote consultations - by phone, video or email - have become more common since the pandemic, and many patients found them helpful. For those with caring responsibilities or mobility issues, they offered a convenient way to access care without needing to leave home.
However, remote appointments weren't suitable for everyone. Some patients lacked privacy at work, while others - particularly those with hearing impairments - found telephone consultations difficult or impossible to use.
What patients consistently wanted was choice, particularly when it came to remote consultations. While in-person appointments were seen as the gold standard, many recognised that telephone or video consultations could be useful in certain situations. Preferences varied widely, which made the ability to choose the type of consultation especially important.
Patients also wanted choice over who they saw, especially for non-urgent issues or when managing ongoing health conditions.
In today's general practice, care is often delivered by a range of professionals, including nurses, pharmacists and physiotherapists. While many patients were open to seeing different healthcare professionals, older adults and people from minority ethnic backgrounds were more likely to prefer seeing a GP.
Overall, patients wanted the option to choose a GP over another healthcare professional - or at least be involved in that decision.
Satisfaction at all-time low
Unsurprisingly, what patients want from general practice varies, reflecting different lifestyles, needs and circumstances. But what was equally clear is that many people are not able to get what they want from the appointment system.
According to a recent British Social Attitudes survey , patient satisfaction with general practice is at an all-time low, with just below one in three people reporting that they are very or quite satisfied with GP services.
Some elements of the UK government's recently announced ten-year plan for the NHS in England may address some of these concerns, but it remains far from certain. The emphasis on the NHS app as a "doctor in your pocket" does not align with what many patients are asking for: genuine choice over whether they access care online or in person.
The proposal to open neighbourhood health centres on weekends could benefit those who need more flexible access. However, simply increasing the number of appointments misses the point: patients want more than just availability. They want care that is accessible, personalised and responsive to their individual needs.
The evidence is clear and the solutions simple, yet patient satisfaction remains at an all-time low. The government must stop assuming technology is the answer and start listening to what patients are actually telling them. The cost of ignoring their voices is a healthcare system that serves no one well.
Helen Atherton receives funding from the National Institute for Health Research and the Research Council of Norway.
