The State of Britain’s GP Service
The UK’s GP service is under increasing pressure, as rising patient numbers coupled with reported reductions in local funding mean GPs
are being stretched to breaking point.
A report by AKEA Life, Thr, Apr 6, 2017
If services are to meet demand, the country will need another 5,000 full-time GPs by 2020, according to NHS England’s GP Forward View. Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, said in March 2017 that demand for health services is increasing as patients live longer and present more complex medical conditions. These issues are increasingly resulting in patients being forced to wait longer or travel further for appointments, while many are experiencing a revolving door of lokum GPs, spelling the end to the traditional GP-patient relationship. In this report, we will examine how patients are being impacted by pressures on GP services in the UK. We investigate how long they are being forced to wait for appointments, how many doctors they are seeing each year, and whether the traditional “family doctor” still exists. This report also explores how patient safety is being impacted by pressures on GP services, as more patients turn to already over-stretched A&E departments or online-only services because they can’t book a GP appointment.
ABOUT AKEA LIFE
Akea Life is a healthcare provider that gives patients the medical advice and treatment they need, when they need it, on their terms.
Akea Life manages the health of our patients proactively, with every patient undergoing a full health check. When they do fall ill, patients receive a rapid call- back service from a GP, followed by a same-day appointment at home or work. With no time limits for appointments, our doctors can spend longer making our patients and their families healthier. We can refer patients immediately for further investigation or treatment with specialists in the NHS or private hospitals. Our extensive network of healthcare providers means that we can offer tests and treatments quickly, conveniently and with the best possible specialists. Akea Life also offers services beyond consultation and referral through our Concierge Service. From blood tests to vaccinations, health screenings, physiotherapy, or even just to get a second opinion. With Akea, there is no waiting to book an appointment, no time off work, and no stress.
- One in 10 patients in the UK have to wait at least two weeks to get adoctor’s appointment with their regular GP
- 43% of patients in the UK don’t know the name of their regular GP
- 42% of patients in the UK don’t know the name of any doctor at theirGP surgery
- Patients in Portsmouth are most willing to travel to see the doctorwith 13% saying they travel more than 50 miles
- 77% prefer to see a regular GP because they will have a better knowledge of a patient’s medical history
- Nearly half of patients (48%) say that seeing the same doctor at every appointment would make them feel less nervous
- Nearly 10% of patients have been seen by four different GPsin the past year
- More than a quarter of GPs (27%) still see at least 3 membersof the same family
- 29% of patients think the doctor they saw in the last year (who wasn’t their regular GP) wasn’t knowledgeable enough about their medical history
- 62% of patients would prefer to see the same doctor at every visit
More than four in 10 patients in the UK (43%) no longer know the name of their GP. And 42% don’t know the name of any doctor in their local GP surgery
With local healthcare services under increasing pressure, as GPs try to deal with increasing numbers of patients, many people are no longer being served by the same GP on a consistent basis. While a third of patients see an average of two different GPs each year, one in five see three different GPs and 10% say they were treated by four different GPs last year. This revolving door of GPs is causing concern for some patients who worry that seeing different doctors means they see won’t have a detailed knowledge of their medical history, and this could put their safety at risk. Around a fifth of patients expressed concern that there have been delays in diagnosis because they have had appointments with several GPs who did not have in-depth knowledge of their medical history.
ARE WE LOSING CONFIDENCE IN THE REVOLVING DOOR OF GP SERVICES?
I have seen different GPs in my surgery, and I have feltlike they have not been knowledgeable enough about mymedical history
|I find seeing different GPs confusing||20%|
|I think seeing different GPs has slowed down the diagnosisprocess for health concerns I’ve had in the past||19%|
|If it was an option I would feel more comfortable seeing a GPin the comfort of my own home||11%|
|I have avoided making a GP appointment as I don’t like going to the surgery||13%|
|I have avoided making a GP appointment as the times haven’tworked for my schedule||16%|
On average, how many different GPs do you see per year?
I know the name of the GP I see (by age)
ARE WE GIVING UP ON GP SERVICES?
Unsurprisingly the vast majority of patients in the UK (62%) would prefer to be seen by the same GP at every appointment.
This is particularly true of female patients, 85% of whom say they would feel more comfortable dealing with the same doctor, although 72% of men share that sentiment. But while some patients are putting up with being seen by different doctors, or waiting longer for an appointment, many others are simply giving up on seeing a GP at all.
More than one in five patients (21%) have put off seeing their local GP in the past year because they couldn’t get an appointment at a convenient time, with the same proportion of patients saying they have put off getting an appointment because one couldn’t be organised soon enough.
17% said they had been told to wait so long for an appointment they had not gone to see a GP at all to discuss their health concerns.
Another 13% said they had not seen their GP about a medical concern because they couldn’t get an appointment at a convenient time – for example outside of working hours.
When it comes to seeing the same doctor more regularly, 77% of patients say this would be better because their GP would be more knowledgeable about their medical history.
More than half (55%) say they would feel more confident seeing the same doctor more regularly because they would feel they’ve known them for a longer time. Knowledge of family history and not having to get to know new faces are also reasons we prefer to see the same doctor.
BEST THINGS ABOUT SEEING THE SAME GP EVERY TIME YOU GO TO THE DOCTOR’S?
|My regular GP would have a lot of knowledge|
about me and my medical history
|I would feel more comfortable talking to them|
as I had known them for a long time
|The GP would have a lot of knowledge|
about my family’s medical history
|I don’t have to have to worry about not being sure|
how they take things, or handle things, as I would
be familiar with their methods
|I wouldn’t have to get to know a new doctor|
|I wouldn’t have to worry about what a new doctor|
thought of my…
Patients in the UK still consider convenience a major factor when determining where to register with a GP.
When moving out of an area, 15% of consumers say they try to remain with the same doctor, and only change if the travel becomes too much of an inconvenience.
Just 13% of people are registered with a GP more than five miles from
Of those patients who have changed GP provider in the past two years, 11% said it was because they had moved too far away and it was no longer convenient to stay registered with the same doctor.
There again appears to be a generational gap when it comes to registering with a GP outside the local area.
Younger people, those aged 18-24, are likely to live more than five miles from their GP (21%) while just 11% of those aged over 55 said the same.
But patients of all ages draw the line at a particular distance, with very few (between 1% and 6%) living more than 10 miles from their doctor’s surgery.
Female patients are more likely to want to stay with their current doctor,
17% said they would rather not change GP even if they moved out of the area.
City breakdown (people who live furthest away from their GP)
DOES THE “FAMILY DOCTOR” STILL EXIST?
The idea of the traditional family doctor seems to be diminishing in the UK with the majority (58%) only having one or two members of the same family registered with them.
More than a quarter of GPs (27%) still have between three and four members of the same family on their register while nearly one in 10 (9%) still see five to six members of the same family. Only 3% of doctors see more than that.
Families in Portsmouth are most likely to be registered with the same doctor, with 19% having seven or eight members on their register, followed closely by those in Manchester (12%).
There is also no generational gap in GP registrations with millennials and baby boomers both just as likely to have one or two members of their family registered with the same GP as them.
THE DOCTOR CAN’T SEE YOU NOW
Increased pressures on GP services mean some patients have to wait longer for appointments for non-emergency treatment or advice.
Some (11%) have to wait as long as two weeks to see their doctor if the appointment is deemed “not an emergency”. 14% are being made to wait a week before they can see a qualified GP.
While 17% of patients are able to see a GP within a day, 12% wait two days, 11% wait three days, and one in 10 wait as long as five days for an appointment.
While these waiting times are proving difficult for doctors to manage and are – at the least – an inconvenience for patients, they are also creating extra pressure on A&E departments, with some patients refusing to wait for an appointment and going into hospital instead.
One in 10 patients say they have attended A&E in the past
year to be seen for non-emergency treatment or advice.
Others have gone at least twice.
Younger people are much more likely to attend A&E for a non-emergency matter, with one in 10, 25-34 year olds saying they went to this department
at least three times in the past year, because they couldn’t get an
appointment with their GP quickly enough.
Waiting times (in days) for non-emergency appointments
THE GP’S RECEPTIONIST
One of the major complaints among patients in the UK is being asked to discuss their medical problems with their GP surgery’s receptionist when booking an appointment.
58% of all people say being asked medical questions by receptionists makes them feel uncomfortable.
Sexual health issues were the topic people felt most
uncomfortable discussing with a receptionist (55%) followed by
mental health concerns (43%)
Asked on their opinions about speaking to a receptionist, a third (33%) said they didn’t it feel it was necessary for them to have to discuss medical issues with a receptionist and should be able to just book an appointment.
There is also no age gap when it comes to this issue, with patients of all ages saying they didn’t like this aspect of booking an appointment with their doctor.
How do you feel having to tell the receptionist at your GP surgery about your symptoms? (by age – either very or a little uncomfortable)
Symptoms or medical concerns we don’t like talking to
|Sexual health issues|
|Mental health (depression, anxiety)|
|Chronic health problems (cancer, diabetes etc)|
|Dermatological (skin problems)|
|Neurological (epilepsy, seizures, nerves etc)|
GP services in the UK are becoming increasingly stretched and it is clear that patients are beginning to notice the impact this is having on local health services.
Despite the vast majority of people saying they would prefer to see the same doctor at every appointment, some have reported seeing as many as four in a year.
This is making it difficult for patients to develop the kind of relationships with local doctors that many older generations have enjoyed.
There also appears to be a diminishing in the traditional “family doctor” with most patients saying only one or two members of their family are registered with the same GP as them.
Large numbers of patients are also being forced to wait long periods of time for non-emergency appointments, as long as two weeks in some circumstances – and some patients are turning away from seeking medical advice because they can’t get an appointment – either quickly enough or at a convenient time.
While this is clearly an inconvenience, it is also increasing the pressure on A&E departments with many patients – mainly younger people – saying they have gone to accident and emergency to seek non-emergency care.
There is also a clear demand among patients to bypass GP receptionists when booking appointments. Being asked medical questions by receptionists is one of the biggest frustrations among patients, and many feel it is not a necessary step to getting an appointment.
What is most clear from this report, is that patients are demanding a more personalised and convenient service.
Longer waiting times, different faces at appointments, and lacking confidence in current systems are causing concerns for patients and the health sector needs to take note of the problem before it is too late.