Since October 2018, NHS Digital have been reporting the number of appointments delivered by GP practices. Their most recent data suggests that appointment rates are now substantially higher than before the pandemic.
So why is it that patients say that they are receiving fewer appointments? In Ipsos’s 2019 GP Patient Survey, 71% of patients reported having an appointment in the last 6 months. This proportion had dropped to 66% in the 2023 survey. The downward trend has occurred in all patient subgroups including older people and those with a long-term condition.
One reaction to this, is to deny the reliability of one or more of these sources. After all, both sources have significant limitations: NHS Digital still regard their appointments data as experimental, and the GP Patient Survey relies on patient recall.
An alternative reaction is to recognise that these data points measure subtly different things. In our recent report we set out some ways in which these apparently contradictory messages might be reconciled.
In some ways, it’s incredible that we know so little about the activity levels of this pivotal NHS service.
Maybe the time has come to move away from consultations or appointments as a headline activity measure for GP practices? 20 years ago, the operating model of primary care was fairly consistent and uniform. Almost all interactions were delivered by GPs in their surgeries. Now we have a plethora of delivery modes, and highly diverse clinical teams. A more granular and differentiated set of currencies would allow for meaningful comparisons between practices and over time.
But this is for the future. What about now? For Integrated Care Boards wanting some guidance on whether consultation rates are rising or falling, a real problem or an artifact of the data? What should they rely on?
We would urge you to reflect on the GP Patient Survey results. Perceptions matter. And, accepting the limitations of survey data, what value are more appointments if patients don’t perceive them and don’t feel the benefit?
In the modern world, data, IT systems and analysis have great power. We shouldn’t let these forces crowd out the voices of real people.