Carol Sinnott

Experiences of access to general practice in England: qualitative study and implications for the NHS 10 year plan Objective To report experiences and views of patients, carers, and staff on access to general practice in England in the context of major government plans to reform NHS services. Design Qualitative i...

Great @bmj.com podcast thebmjpodcast.podbean.com/e/bmj-jan-30... featuring the mighty @hughalderwick.bsky.social and @luisaptg.bsky.social talking about our paper on experiences of access to general practice and the 10 year plan. www.bmj.com/content/392/...

Access to #GeneralPractice is a public priority- but what can we expect from the solutions expounded by the NHS ten year plan? Our new study in @bmj.com offers a glimpse of what the future might hold…
#PrimaryCare #FamilyMedicine

This large qualitative study published in the BMJ suggests that the "three shifts" proposed in the 10-Year Plan for health may not be what patients are seeking nor what practices want to support better access to general practice. www.bmj.com/content/392/...

Experiences of access to general practice in England: qualitative study and implications for the NHS 10 year plan High quality primary care is strongly associated with better functioning of healthcare systems, enabling the needs of most patients to be met by offering first contact care for undifferentiated illness, comprehensive care across the lifespan...

How will the shifts to digital, community & prevention set out in the English NHS 10-year plan affect access to general practice? @thisinstitute.cam.ac.uk​ asked patients, carers & NHS staff about their experiences of access.

Read more in this new paper ⬇️

Giving you more control over your health and care.

Will access to general practice be affected by the #NHS10YearPlan? There needs to be clarity about what this offers for patients, what “good enough” looks like for access & careful co-design & evaluation of the detail of each of the 3 shifts.
Full paper: ths.im/4b6oPWp
THIS Summary: ths.im/49oDU4k

Big qual study on access to general practice

Changes linked to 10 year plan offered some benefits, but also unintended effects—including undermining continuity and human connection, fragmentation of care, and widening inequities

Careful design, implementation, and evaluation of new services needed

It's now 20 years since we came up with the candidacy framework for explaining access to healthcare. Now, our scoping review shows how candidacy has been used in research on access to general practice. It seems to be useful and actionable - good news! journals.sagepub.com/doi/epub/10....?

Among many others I have struggled to understand why ‘neighbourhood health’ should replace really good primary care. This study underlines some of the challenges.

Access to general practice is a growing problem, with long waits, lack of appointments & unmet patient needs. Our review shows the candidacy framework offers a more nuanced way to understand access, beyond appointment numbers & waiting times.

Full paper ths.im/4aljBFS
THIS summary: ths.im/4iZqTBe

GP woman attending to a patient by reviewing the blood pressure.

Our review shows that the candidacy framework can help explain why improving access to general practice is so complex. It highlights issues that affect how people seek care but may benefit from updating to reflect general practice changes.

Full paper: ths.im/4aljBFS
THIS summary: ths.im/4iZqTBe

Woman looking at her phone

Making it easier to get appointments is the public’s top priority for the NHS. We reviewed 40 years of interventions into a themed catalogue to help guide improvement efforts.

THIS summary: ths.im/3MlV1dS
Full paper: ths.im/44DALL2

Group of people in a GP surgery. Woman holding a phone.

Access to healthcare is often focused on speed and supply, but this doesn’t consider other crucial aspects of people’s experiences. The candidacy framework can help understand access to general practice more broadly.

Full paper: ths.im/3Kz0Vb4
THIS Summary: ths.im/4phBVnH

NEW @bmj.com research reports experiences of access to general practice in England.

It finds that the three proposed shifts in the NHS 10 year plan may not be what patients or practices want
www.bmj.com/content/392/...

Read our new review of how the candidacy framework has been used in research on access to general practice here:https://journals.sagepub.com/doi/10.1177/13558196251406207

Hoping our catalogue of 449 different efforts to improve access to general practice will be useful for policymakers, clinicians and patients. The paper summarises our findings. The entire list is in supplementary data 4 here: bjgpopen.org/content/bjgp...

Illustrative

What’s been tried? A curated catalogue of efforts to improve access to general practice
➡️ doi.org/10.3399/BJGP...
‬Using 449 different sources, this review offers a comprehensive, thematically curated catalogue of attempts to improve access to general practice.

Hoping our catalogue of 449 different efforts to improve access to general practice will be useful for policymakers, clinicians and patients. The paper summarises our findings. The entire list is in supplementary data 4 here: bjgpopen.org/content/bjgp...

Women in the foreground with two people in the background waiting in a waiting room

Despite 40-plus years of interventions, patient satisfaction with access to NHS general practice continues to drop. We reviewed and sorted 449 previous attempts at improving access into a catalogue for policymakers, researchers, and clinicians. THIS summary: ths.im/44njDJG Full paper: ths.im/4lgXkew

In patients with #Insomnia disorder, low-dose mirtazapine and, to a lesser extent, amitriptyline, improved insomnia severity compared with placebo at 6 weeks, but not from 12 weeks onwards doi.org/10.3399/BJGP... #PrimaryCare #GeneralPractice

💡 Despite record numbers of appointments, patient satisfaction with access to NHS general practice is declining. With @healthfoundation.bsky.social we reviewed 40 years of interventions into a themed catalogue to help guide improvement efforts.

Many, many, many things have been tried in trying to improve access to general practice. @thisinstitute.bsky.social and @healthfoundation.bsky.social have curated those efforts: bjgpopen.org/content/earl...

Challenges to quality in contemporary, hybrid general practice: a multi-site longitudinal case study - PubMed Contemporary hybrid general practice features changes (digitalisation, physical distancing, extension of roles, and protocolisation) that have had the unintended effect of dehumanising, compromising, ...

H/t this recent @bjgp.bsky.social paper by @trishgreenhalgh.bsky.social and the RBD2 team, pubmed.ncbi.nlm.nih.gov/39117426/

Investigation report: Continuity of care - delayed diagnosis in GP practices Full online version of the Health Services Safety Investigations Body (HSSIB) investigation report 'Continuity of care: delayed diagnosis in GP practices'.

Engaging reflections here on the unintended consequences of GPs only seeing the most complex patients without any lower acuity consultations. Consequences include decision fatigue, an inability to "reset" between patients, and decreased performance: www.hssib.org.uk/patient-safe....

Looking at how people access (and can’t access) general practice – lessons to take into action Quickly and easily listen to BJGP Interviews for free!

Conversations around GP access often focus on appointment waiting times & availability but miss key factors that impact patients' overall experiences with access. @cmsinnott.bsky.social explores these factors with @nadakhan.bsky.social in this @bjgp.bsky.social podcast:

Really looking forward to this session- do join us for what promises to be an enthusiastic conversation and fresh look at problems relating to access to general practice.

Thanks @nadakhan.bsky.social and @bjgp.bsky.social for giving me the chance to share our recent work on access to general practice with you on this podcast!

The #CandidacyFramework offers a way to examine improving #GeneralPractice access through a candidacy lens. Does the patient believe they are a candidate for health care?

🎧Podcast: www.bjgplife.com/189
📖 Paper: doi.org/10.3399/BJGP...
🎬 1-min Video: youtu.be/JJLR2QlG5cg

#GPworkforce #PrimaryCare

The key is to feel there is someone there – yes, a doctor – who cares about you.

Hugely important. But I can attest that high quality, human care does survive for myself and my family. And that phone, text and email can work together to materially improve communication between patient and practice and improve its efficiency.

Challenges to quality in contemporary, hybrid general practice a multi-site longitudinal case study Background Since 2022, general practice has shifted from responding to the acute challenges of COVID-19 to restoring full services using a hybrid of remote, digital, and in-person care. Aim To examin...

Our new paper, out today:

Challenges to quality in contemporary, hybrid general practice: a multi-site longitudinal case study.

Is grim reading. Lead author was @oohgpwales.bsky.social

bjgp.org/content/earl...