How changes to access have affected people's experiences of using GP services

In this interview, Kellie reflects on how access to GP services has changed over the past four years and considers whether familiarity and continuity of care make a difference to patients' experiences. Her story forms part of our Four years on: Patient experience of GP access project, which explores how people are navigating an evolving primary care system.

How has your experience of getting a GP appointment changed over the past four years?

“It has definitely got harder because they are pushing everything digital. I always call up, and when you can get through to the reception staff, there is little interaction with them anymore, and not much help when trying to book an appointment.”

What changes have you seen since the COVID-19 pandemic?

“A lot of surgeries have not returned to normal working practice since COVID-19; there are a lot more telephone consultations, which may be good for some people, but not for others, and I personally find them a waste of time. How can a GP know what is physically wrong with you when the consultation is over the phone? I see it as a guessing game, and it puts me off calling for an appointment”

What other challenges to access have you seen in the past four years?

“I have also noticed that central phone lines have changed. All calls to my local GP now go to another surgery in the Trust, one that I don’t use. This new initiative has not been promoted to patients of the Trust. There has been a loss of continuity to the practice people have been going to for many years.

“Some surgeries in Wolverhampton won't let you book appointments at the desk. What provisions are being made for people who are elderly, English is not their first language or disabled.”

“They have taken services away. At my surgery they have a practice nurse, but they no longer do blood tests, so if I need one I'm sent to another surgery. I don’t drive, so this can be an issue for me.

“GPs are also not offering medication to people over the phone. Due to struggling to walk and not being able to drive, this can be difficult for me to get to the GP to file for a repeat prescription.”

What changes have you observed in patient and GP interactions, and how has this impacted access to GPs?

“The GPs sometimes don’t even look at me during a consultation. They seem more fixated on their computer screens than actually focusing on their patient.

“There have also been times when the GP has said to me, ‘What can I do for you today?’ I don’t think this is very patient friendly, and this sort of approach from GPs could really put people off. Years ago, it was much more patient focused, and you were able to form a rapport with them.” 

How important is it to you to see the same GP?

“I believe it's very important. It stops you from repeating your medical history over and over again. If you have had a traumatic accident or event, and if you see the same GP, they will eventually understand. When I used to be a carer for my husband's mother, I didn’t have to repeat the same issues to other healthcare professionals, and I felt comfortable going back to the GP every time.

“It can be hard to open up about certain issues, and with mental health on the rise, people need to be able to have that rapport with their GP’s to open up and help build a picture of themselves. How can two different GPs tell you have changed from the last appointment you had with them.”

What happens when you can't get an urgent appointment at your GP?

“If I can't get an urgent appointment, I go to the walk-in centre near my house. I feel that if we didn’t have them, we would all be going to A&E. Walk-in centres are really good for Wolverhampton, and we need more of them. They also allow you to ring 111 to get an appointment there if the GPs are closed.”

Have you ever been told by your GP to attend A&E?

“Yes, once before. I had a problem with my knee, and my GP told me that it was quicker to go to A&E due to the waiting times at the surgery. I definitely feel that someone needs to look into the number of people referred to A&E from their GP every single day.”

Do you have any ideas that you would like to share on how GP access could be made easier for you? 

“I think there needs to be a wider promotion of walk-in centres. I feel that there are a lot of people in Wolverhampton who are unaware of them. If the promotion is improved, there could be less pressure on GP’s and to stop people going to A&E.

“I also think there needs to be a survey asking patients what works well, what needs changing and so on. I don’t believe any changes being made at the moment are consulted or even patient friendly. What works for one group of people may not work for another.”