CDPS research highlights access challenges to GP services in Wales
People directly affected by public-facing digital technologies – the citizens of Wales – should be involved at every stage in their design
17 August 2022
Digital technology offers enormous potential for improving access to services yet contacting GP practices and getting an appointment remain the biggest challenge for citizens. For GP practices, managing increasing demand is the greatest issue – despite new digital tools that could make patient access easier and help to reduce pressure on practices, the CDPS discovery project into Welsh primary care has found.
The impact of the pandemic, the fact that people are living longer – often with complex health needs – combined with a shortage of GPs, partly explain the challenges of access and demand management.
What we discovered
CDPS’s 12-week discovery, which ended on 1 April 2022, sought to understand these challenges better from the citizen and GP practice perspective.
The discovery team’s last blog post shared early findings from our research with GP practices and citizens. Since then, with more research, we’ve reached some conclusions about access to GP services in Wales, focusing on digital tools.
Our top 4 findings are:
1. Expanding health records access online for citizens offers benefits and challenges
A GP practice told us that giving citizens such access:
“Encourages people to take ownership – they are aware of what the results are”
2. Getting access to GP services remains the main challenge for citizens
Citizens told us they struggled to get through to surgeries on busy phonelines, relying on what some called “potluck” or sheer persistence. They reported having to redial to join call queues and queuing for 20-50 minutes each time they called. Some found it easier to visit the practice in person.
3. Managing demand is the main challenge for practices
How GP practices manage demand from calls and other channels varies. Each method has its problems – taking recorded messages as an example:
- ‘Call first thing in the morning’ for appointments – creates a bottleneck and frustration for citizens
- ‘Call between X and Y time for appointments’ – does not resolve bottleneck; just moves it to another time
- ‘Call at X time for test results and Y time for prescriptions’ – GP practices do this to spread calls across the day, but it can be difficult for people to remember when to call, resulting in calls throughout the day, anyway
4. Digital tools have not been consistently successful
Digital interventions have been widely used in other sectors to mitigate access challenges. However, they have not been consistently successful in primary care in Wales. We found several reasons for this.
Some of them were caused by the pandemic. But broadly speaking, digital tools have been too often procured and deployed without enough understanding and consideration of:
- the detailed needs of the citizens or practices who will use and run them
- how they will work together with the rest of the public-facing services that practices offer to citizens
This has led to confusion and frustration for some citizens and a perceived increase in demand for some practices. Practices have reacted by turning off or otherwise limiting access to different types of digital functionality.
What we’ve done since
The discovery team has produced a detailed report describing:
- what we’ve learned from our research
- the evidence behind it
- our conclusions, including recommendations for more focused research to follow
At the heart of our recommendations is the need to involve people directly affected by policies or tools in the design, selection and testing of public-facing digital technologies.
The team presented our findings to GPs and others with an interest in GP services at a show and tell (project update) at the end of March this year. We then presented a detailed report to Digital Services for Patients and Public (DSPP), Digital Health and Care Wales and the Welsh Government.
What happens next?
DSPP is now considering our research conclusions for developing digital public services with GP practices.
Read the full primary care pathfinder discovery report.
Watch: Deputy Minister Lee Waters describes CDPS’s achievements in our first year