Focus on face-to-face GP appointments to boost patient satisfaction, practices advised

GP practices wishing to boost patient satisfaction should prioritise supplying face-to-face appointments over speed of access, researchers have indicated.

Higher numbers of face-to-face GP appointments have been associated with higher patient satisfaction, a new study of more than 5,200 GP practices in England has found.

Researchers from the University of Manchester used national appointment data to investigate the relationship between the volume and type of appointments and patient experience.

They found that satisfaction levels were lower in practices that rely more both on telephone appointments and consultations with non-GP staff.

The study looked at a data set of over half a million English patients from 5,278 practices, taken from the General Practice Patient Survey and NHS Digital appointment data, covering August 2022 to March 2023.

It found that:

• 69.5% of appointments were face-to-face and 27.2% were on the telephone
• 29.6% of appointments were face-to-face with a GP and 18.4% were GP telephone appointments
• Greater numbers of appointments of any type with any staff member overall resulted in improved patients satisfaction
• Greater numbers of GP appointments at a practice were associated with ‘reduced unmet health needs’
• Practices offering more on the day appointments had ‘reduced satisfaction with access’ compared to practices that offered appointments days or weeks in advance.
• Practices with a larger amount of telephone consultations ‘had less satisfied patients’. This dissatisfaction was still present and decreased only slightly when telephone calls were carried out by GPs, rather than non-GP staff.

The correlation coefficient between face-to-face appointments and overall satisfaction was 0.096, showing that practices with a greater percentage of face-to-face appointments were more likely to have patients with higher overall satisfaction.

However, the figure for GP face-to-face appointments was 0.167 showing that GP face-to-face appointments have an even stronger correlation.

The study, published in the British Journal of General Practice, suggested that initiatives to improve patient satisfaction in general practice should ‘prioritise increasing the availability of face-to-face GP consultations’.

It said: ‘This research provides evidence that higher volumes of face-to-face appointments, particularly with GPs, is associated with enhanced patient satisfaction, better continuity, and a reduction in unmet health need.

‘The analysis found that more on-the-day appointments were negatively associated with patient satisfaction.’

Study author Dr Patrick Burch, a GP and academic clinical lecturer at the University of Manchester, said that a greater proportion of telephone appointments were associated with ‘decreased satisfaction in general’, especially when provided by ‘non-doctor roles’.

Last year, a different study warned that falling full-time GP numbers ‘could lead to a tipping point’ where most general practice appointments are no longer delivered by GPs.

Dr Burch said: ‘This study of appointments from over 5,500 practices showed that more appointments, particularly with face-to-face with GPs, tended to be associated with more satisfied patients who were better able to meet their health needs.

‘While telephone and IT assisted appointments have an important role to play in general practice, we would cautiously welcome an overall increase in the proportion of face-to-face consultations.

‘Until recently, simply employing more GPs was not seen as feasible. However, given six out of 10 job-seeking GPs have struggled to find a vacancy to apply for over the past year, this may now be a potential option. We would also welcome measures that free up GP time to enable more patient appointments.’

Dr Burch added that the reasons for the findings behind this study are ‘likely to be complex’, and that there is ‘undoubtedly’ an important role for non-GP clinicians in primary care.

‘Patient satisfaction is not the only measure of success in general practice but it is important that policy makers take note of the link between patient satisfaction and numbers of appointments with GPs,’ he said.

In response to the study’s findings, RCGP chair Professor Kamila Hawthorne said that how a patient accesses their care ‘should be a shared decision’.

She said: ‘This study shows that when patients have better access to their GPs, satisfaction with their care rises.

‘But too many of our patients are still struggling to get appointments when they need them, despite GPs working harder than ever to ensure that they receive safe and timely care.

‘The wider GP team – including practice nurses, physiotherapists – are highly valued and can provide excellent care for patients when it isn’t necessary or appropriate to see a doctor.

‘But these team members are not GPs and should not be used to plug gaps in the workforce that have been created by years of underinvestment and poor workforce planning by successive governments.

‘We have been encouraged by commitments from this Government to redirect funding towards primary care and bring back the family doctor – but general practice has faced decades of neglect, and we need to see action to turn things around.’

A DHSC spokesperson said: ‘GP services are buckling after years of neglect but through our Plan for Change, we are working with them to fix the front door of the NHS. 

‘We are hiring 1,000 more GPs and have announced the biggest boost to GP funding in years – an extra £889 million.

‘This government is determined to bulldoze bureaucracy, so GPs spend less time filling in forms and more time caring for patients.’

It comes after the latest GP Patient Survey in July found that three quarters (73.9%) of patients rated their ‘overall experience’ of their GP practice ‘good’.

And a large 2022 study found that employing healthcare workers other than GPs or nurses led to a drop in patient satisfaction.