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NHS England does not “fully understand” demand or capacity of practices


27 November 2015

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The National Audit Office (NAO) has said that both NHS England and the Department of Health are trying to improve access to general practice, but are making decisions without fully understanding the current system.

The National Audit Office (NAO) has said that both NHS England and the Department of Health are trying to improve access to general practice, but are making decisions without fully understanding the current system.

The report, released today, showed that nationally 92% of people live within two kilometres of a GP surgery, but there are large differences between urban and rural areas. Only 1% of people in urban areas do not have a GP surgery within two kilometres, compared with 37% in rural areas.

It also found that the definition of good access varied between patients groups, The data indicate that: in 2014-15, 75% of patients aged 75 and over had a preferred GP, compared with 38% of those who are under 75 and generally well.

Similarly, a survey the Office (their premises in London pictured) commissioned in September 2015 found that 58% of people aged 18 to 64 felt being able to book a same-day appointment was important, compared with 49% of respondents aged 65 or over.

In order to improve access and limit the need for GP appointments, the NAO report recommended: “NHS England and clinical commissioning groups should influence people’s behaviour to help practices make best use of available capacity. Most patients want to see a GP, but GPs make up only 29% of the general practice workforce and they alone are unlikely to be able to deal with the rising demand for services.

“NHS England and clinical commissioning groups should raise people’s awareness about the different options available and when to use them. General practices themselves also have an important role to play in influencing people’s behaviour.”

However, people’s experience of accessing general practice remains positive, with almost 9 in 10 patients reporting in 2014-15 that they could get an appointment. Patient satisfaction with access is, however, gradually and consistently declining, and a fifth of patients report opening hours are not convenient.

Amyas Morse, head of the National Audit Office, explained: “Against the background of increasing demand and pressure on NHS resources, the challenge is how to maintain people’s positive experience of accessing general practice and reduce variation.

“The Department of Health and NHS England are working to improve access, but are making decisions without fully understanding either the demand for services or the capacity of the current system. Better data is needed so that decisions about how to use limited resources to best effect are well-informed.”

Among the NAO’s recommendations are that NHS England should improve the data it collects on demand and supply in general practice, and research how different practices’ appointment-booking and other working arrangements drive variations in access.

“While making changes designed to improve access, NHS England should analyse the impact on different patient groups,” the report read.

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