The current NHS system for seeking care “is not fit for purpose”, according to a review, which recommends new neighbourhood teams to improve access for patients.
The “stocktake” commissioned by NHS England and led by practising GP Dr Claire Fuller said the current system is “fragmented and causing frustration” for patients wanting GP appointments, and also frustrates staff.
It calls for a more streamlined system for the way people access NHS urgent care in England, bringing together online advice, community pharmacies, GP surgeries, out of hours, urgent treatment centres and NHS 111.
These “separate and siloed services” should be organised into a “single integrated urgent care pathway” in the community “that is reliable, streamlined and easier for patients to navigate”.
The report noted that some regions already have teams “working as a single urgent care team, including allied health professionals, community nursing teams and others to offer their patients the care appropriate to them when they call the surgery or book an online appointment”.
It added: “We need to enable primary care in every neighbourhood to create single urgent care teams and to offer their patients the care appropriate to them when they pop into their practice, contact the team or book an online appointment.”
Dr Fuller said people waiting for an appointment with their GP “prioritise different things” and this needed to be recognised.
She added: “Some need to be seen straight away while others are happy to get an appointment in a week’s time.
“Some people – often, but certainly not always, patients with more chronic long-term conditions – need or want continuity of care, while others are happy to be seen by any appropriate clinician, as long as they can be seen quickly.
“Equally, for some patients it is important to be seen face to face while others want faster, more convenient ways of accessing treatment and there is emerging evidence of a growing appetite (even before Covid-19) for patients to access care digitally.”
The new report said bringing together a range of services would free up time for those with long-term conditions and who need care from the same professional.
“Inadequate access to urgent care is having a direct impact on GPs’ ability to provide continuity of care to those patients who need it most,” the report said.
“In large part because of this, patient satisfaction with access to general practice is at an all-time low, despite record numbers of appointments: the 8am Monday scramble for appointments has now become synonymous with patient frustration.”
NHS chief executive Amanda Pritchard, who commissioned the review, will now work to implement the recommendations.
She said: “General practice is the bedrock of the NHS, acting as the front door to healthcare with GPs and other primary care professionals providing treatment, advice and support to more than one million patients every day.
“I have heard how much people value access to these vital services which is why I commissioned this stocktake to ensure that as we join up services through Integrated Care Systems, we make it as convenient as possible for everyone to get the right care for their needs at the right time.”
Dr Fuller said: “As a GP, I know only too well the importance of supporting people – patients who come to my surgery might present with a medical condition but so often this is exacerbated by other factors; financial concerns, housing issues or poor air quality.
“Newly formed Integrated Neighbourhood Teams, which should evolve from Primary Care Networks, are perfectly placed to bring together the right partners to tackle people’s overall health and wellbeing needs.”
Professor Martin Marshall, chairman of the Royal College of GPs, said: “The report outlines a direction of travel that the college has long advocated, with GPs providing system leadership, supported to work within integrated multi-disciplinary health and care teams to ensure patients receive appropriate and timely care for their health needs, and to provide continuity of care for those who need it most.
“Delivering this vision, as the report recognises, will depend on progress being made to expand the general practice workforce, and provide the resources to ensure that GPs and our teams are working in premises that are modernised, digitally-enabled and have the space to accommodate an expanded workforce and diagnostics in the community.”
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