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Have new arrangements improved access to GPs?

Press release issued: 4 December 2007

Advanced Access, a new approach to booking appointments with GPs, provides slightly faster access to an appointment, according to research carried out by the University of Bristol. However, patients in practices that have adopted the system found it harder to book appointments in advance.

Advanced Access, a new approach to booking appointments with GPs, provides slightly faster access to an appointment, according to research carried out by the University of Bristol.  However, patients in practices that have adopted the system found it harder to book appointments in advance.

General Practices were encouraged to introduce Advanced Access in response to the NHS Plan target that people should be able to get an appointment with a health professional within 24 hours and with a GP within 48 hours. 

Advanced Access, an approach imported from the United States, is based on theories about how queues operate.  It suggests that by measuring the demand for appointments, matching supply to demand and introducing new ways of working, people should always be offered an appointment as soon as they wished.  However, as practices introduced these ideas and tried to meet the NHS Plan target people complained that they found it harder to book an appointment in advance at a time it suited them, and found it harder to see the doctor they wished.

Chris Salisbury, Professor of Primary Health Care, and colleagues conducted a programme of research about access to general practice in collaboration with colleagues from the Universities of Sheffield, Southampton and Brighton and Sussex Medical School. 

They found that practices operating Advanced Access provided slightly faster access to an appointment but patients in these practices found it harder to book appointments in advance.

There was no evidence that patients in Advanced Access practices found it harder to see a particular doctor.  Both types of practices provided considerably more appointments and saw more patients following the introduction of the NHS access targets.

Access to General Practice was generally good, with almost half of all patients being seen on the same day as they requested an appointment. However speed of access was not in itself the most important thing for people.  A higher priority was being able to make an appointment at a convenient time, and for some groups of patients to see a particular doctor.

Professor Salisbury said: “These findings illustrate the importance of flexibility in how appointment systems are designed in order to meet the different needs of different groups of patients.  They also highlight the importance of being cautious about widespread implementation of new ways of working imported from other health care systems, such as the USA, before there is good evidence that these changes are effective and beneficial in the context of the NHS.”

The results have been published in a report from the NHS Service Delivery and Organisation (SDO) Programme.

Further information

Please contact Hannah Johnson for further information.
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