Convoluted systems block access to GP appointments

Centrally imposed systems for booking GP appointments and the effort needed to keep them working to improve access for patients is having the opposite effect, according to new research led by the University of Southampton and the University of Oxford.

GP surgeries are delivering more consultations than ever before, with approximately 367.5 million in 2024 , up from 312.1 million in 2019.

But ‘persistent tinkering’ to booking systems is confusing and frustrating for patients and causes significant work for GP staff.

The tinkering is, however, a necessary response to continually adapt the top-down systems to keep them working.

This is compounded by blanket nationwide policies that do not consider local needs.

The study involved in depth research in eight GP practices in different demographic areas and geographic locations across England.

Study co-lead Helen Atherton, Professor of Primary Care Research at the University of Southampton, said: “General practices are constantly tinkering and amending their access systems to try to make them work for their patients. They should be supported to do that.

“At the moment, systems are managed top-down from the Government. But that does not necessarily take account of what people want and need. A better approach would be to allow individual general practices to do what works for their population.”

Widescale policies implemented for all general practices is a problem, according to the research which is published in the British Journal of General Practice .

“There are a lot of blanket policies, such as the policy implemented in October that instructs all GP practices to offer online consultations from 8.30am to 6pm,” said Professor Atherton. “But that takes practice staff away from doing other things that may be more pressing or effective. Everything that is put in place to improve access is actually creating more work and challenging what practices are able to do.”

The study also questions why access to GP appointments is exclusively focused on managing demand, rather than providing access.

Study co-lead, Professor Catherine Pope, from the Nuffield Department of Primary Care Health Sciences, University of Oxford, said: “Practices tend to view patients as a big group of people all demanding access, but they are of course individuals with individual health concerns. General practices may need to challenge their thinking about patient needs and wants in relation to access and consider how they can humanise a process that has become complex and technical.”