Steve Black critically examines the recent report by the Institute for Government on general practice in England, challenging its assertion that increasing face-to-face GP appointments will improve patient satisfaction. The report identifies three key factors as influencing patient satisfaction: the number of GPs per patient, the prevalence of in-person appointments, and the size of practices.
The first claim is supported by data showing significant variation in patient-to-GP ratios across regions. In areas with more GPs per patient, satisfaction tends to be higher. This is evident in the disparity across integrated care boards, where some regions have no practices with more than 5,000 patients per GP, while others have most patients under more strained ratios.
However, the claim that more face-to-face appointments would enhance satisfaction is less clear-cut. The report relies on data from the GP Patient Experience Survey, which correlates higher patient satisfaction with the number of in-person appointments. But as Black points out, this data is fundamentally flawed. It overlooks the quality of remote appointment systems, the variability in implementation, and patient preferences for remote or online consultations.
A study by the Health Foundation sheds light on this issue. Analysing data from 150 practices using the AskmyGP triage tool, the research found that fewer than a third of patients requested face-to-face appointments, even before the pandemic. During COVID-19, the demand for in-person consultations dropped to under five percent and has since stabilised below twenty percent. This data contradicts the report’s implication that more face-to-face appointments are universally desired.
The study also reveals that when patients were given a choice of appointment modes, the majority opted for online or phone consultations. This preference highlights the importance of well-designed, effectively implemented remote communication systems: a factor largely ignored in the report’s analysis.
The third claim regarding smaller practices is similarly questionable. Black argues that the report’s focus on practice size overlooks more critical variables, such as the quality of patient interactions, the effectiveness of digital tools, and the ability of practices to provide timely responses to patient needs.
Ultimately, Black contends that the report’s recommendations miss the mark by focusing on outdated metrics like appointment mode rather than addressing the broader context of patient preferences and the quality of remote healthcare delivery. By prioritising in-person appointments without considering the nuances of digital consultation systems and patient choice, the report risks perpetuating misconceptions about what truly drives patient satisfaction in today’s healthcare landscape.
