GP Access in Liverpool: "A Good service, when you get in" - August 2023 Report
At Healthwatch Liverpool we know it is important to people to be able to contact their GP when they need to, and in a way that works for them. We also know, from what people tell us, that they do not always feel that they CAN access their GP as easily as they would like to.
We decided to work on this project because we know from patient feedback and reports in the media that many people have struggled recently to get an appointment with their GP practice, and that this has worsened because of the lasting impacts of the Covid-19 pandemic.
Our overarching focus is currently on Equality, Diversity and Inclusion, but we are always interested in gathering feedback on the general experience as well as the experience of those getting unequal care and access. Our GP project aims to do both these things. The move to remote access and ‘total triage' has had a variable impact, so we wanted to know whether some people find it harder than others to access the advice, support and information they need from GPs, and what is being done to make access to GPs more equal.
Key findings
We received feedback from 225 people. Our key findings are set out below:
- A majority of people prefer to contact the GP by phone, followed by going in in-person.
- The most popular phone system included a call-back option. People also like to know where they are in the queue.
- There were mixed views on eConsult; some people said they had to lie on the form to avoid being advised to go to A&E. Some found it easy to use, others didn’t.
- GP websites varied in the information they provided and in how accessible they were, including for speakers of other languages.
- Older people were more likely not to use the internet and there were some examples of older people falling through the gaps.
- Most patients were unfamiliar with the roles of ARRS staff (Additional Roles Reimbursement Scheme e.g. Social Prescribing Link Workers, pharmacists, physiotherapists).
- Most patients were unaware of the Enhanced Access scheme which was introduced in October 2022.
- Practice managers told us that practices are under enormous pressures, and many struggled to recruit staff to cover higher demand from patients.
- Older people, people with sensory disabilities and speakers of other languages faced additional problems in accessing GPs/primary care.
We know from NHS Cheshire & Merseyside Integrated Care Board (ICB), Liverpool Place that work is already happening around some of these, for example improving/increasing the ways to access GP practices.
Recommendations
GPs are the first port of call for further care, diagnostics, hospitals and other secondary and tertiary care. If patients fail to get access to GPs, they fall at the first hurdle and may go without care that they need or need treatment for a late emergency presentation.
One of our rolesis to use feedback from the public to help improve services for patients. To do this we can highlight good practice, based on evidence from feedback, where patients have been satisfied with their experience of GP services, as we have tried to do in this report.
We can also highlight concerns raised by patients and make recommendations about how these could be addressed, and by whom. For instance:
- Individual GP practices
- Primary Care Networks (PCNs) - which are groups of GP practices working together with community, mental health, social care, pharmacy, hospital and voluntary services in their local areas
- NHS Cheshire & Merseyside Integrated Care Board (ICB)
- Cheshire & Merseyside Health & Care Partnership Integrated Care System (ICS)
- Liverpool Place - our local NHS Commissioning Team
- NHS England (NHSE)
We will have had an impact if we see GP practices adopt the recommendations that we set out below:
- All practices should adopt new telephone systems that include a callback option and a queue system as soon as practically possible. Where practices struggle to fund new systems, Commissioners should provide support using NHSE and additional funding as required. (NHSE, ICB)
- Improved communications with patients/the public to explain why/how things have changed at GP practices. This should include information about Additional Roles Reimbursement Scheme (ARRS) staff and the treatment and support they can offer. (ICB, Liverpool Place.)
- More local publicity to inform patients about Pharmacy First, including in community languages, BSL and Easy Read. (ICB, ICS, Liverpool Place)
- More local publicity is needed to inform patients about Enhanced Access, making it clear that it won’t necessarily be at your practice and may have transport implications. This should also be available in a range of community languages, BSL and Easy Read. (PCNs)
- Regular training for reception/administrative staff on how to flag language support needs (including BSL and Easy Read) and reasonable adjustments on patient records. For instance, to improve consistency, commissioners could provide standardized training programmes, online and/or via Primary Care Networks and monitor completion by relevant staff. (Individual practices, PCNs, ICB)
- Additional funding for Link Workers to support communities/individuals with limited English language skills, to address existing health inequalities and prevent the widening of these inequalities. (Central Government)
- Increase cultural and linguistic diversity amongst staff to reflect changing local demographics and extend this to having deaf-aware staff and encouraging BSL speaking staff to apply. (Individual practices, PCNs)
- PCNs to work proactively with Merseyside Society for Deaf People (MSDP) around the BSL Act, as some Hospital Trusts have done. (PCNs)
- PCNs to work proactively with learning disability service providers (e.g. People First and Mencap). (PCNs)
- GP websites should include information on booking appointments with all healthcare professionals based at practices, not just GPs. (Individual practices)
- GP websites should adhere to good practice on basic minimum information to include and should review their websites regularly to ensure that all information is correct/up-to-date, including providing up-to-date catchment area maps and links to translated/BSL/Easy Read information. (Individual Practices.)
- GP website builders should check that sites work with a range of browsers and devices. (Informatics Merseyside, Individual Practices.)
We will continue to monitor patients’ feedback about GP access and will continue to carry out practice visits as part of our ongoing engagement programme. Over the coming months we hope to hear increasingly positive feedback from patients who feel they are able to access their GP practices more easily.
Downloads
If you need this report in a different format, please email enquiries@healthwatchliverpool.co.uk or call 0300 77 77 007.
