Written evidence submitted by Healthwatch England (FGP0310)

 

About us

 

We are the independent statutory champion for people who use health and care services. Our job is to make sure that those who run local health and care services understand and act on what really matters to people.

 

A local Healthwatch exists in every area of England. We support them to find out what

people want from health and care services and to advocate for services that work for local

communities. Local Healthwatch also act as our eyes and ears on the ground, telling us

what people think about local health and social care services.

 

We use the information the network shares with us and our statutory powers to ensure the voice of the public is strengthened and heard by those who design, commission, deliver and regulate health and care services.

 

General Practice

Access to General Practice has for a long time been the issue people talk to us about the most – both prior to and during the pandemic. The COVID-19 pandemic has fundamentally changed the way we use our GP practice. Instead of phoning for an appointment or walking-in to a surgery, access to care has rapidly moved to online bookings, and video and phone consultations.

For some people the rapid digitalisation of care has worked. Our previous report The Doctor will Zoom you now (which we published because service delivery was changing so quickly during the early stages of the pandemic and we wanted to provide rapid, useful insights to the NHS) highlighted how for many, remote consultations were more convenient, making access to care quicker, more efficient and easier to fit around their lives. Therefore, it is important that where people’s experiences of accessing care have improved, that we acknowledge this and make the improvement a permanent feature of the system.

On the other side of the coin, it is also clear that many people were also struggling to access care from their GP, often simply because they can’t and/or do not know how. This is leading to people feeling that GP practices are not ‘open for business’ or that they should not seek care for their health issue because of the pressures the pandemic has placed on the NHS. This puts people’s health and wellbeing at risk and increases demand on overstretched hospitals – both from those who cannot get a GP appointment so seek care at A&E, and from people who now need more advanced care and treatment because they were unable to get help sooner. Our ‘Locked out: Digitally excluded people’s experiences of remote GP appointments’ report from June 2021 identifies five principles for post-COVID digital healthcare:

  1. Maintain traditional models of care alongside remote methods and support people to choose the most appropriate appointment type to meet their needs. 
  2. Invest in support programmes to give as many people as possible the skills to access remote care.
  3. Clarify patients' rights regarding remote care, ensuring people with support or access needs are not disadvantaged when accessing care remotely. 
  4. Enable practices to be proactive about inclusion by recording people's support needs.
  5. Commit to digital inclusion by treating the internet as a universal right.

Just prior to this, as part of our extensive review of people's access to GP services, (drawing on almost 200,000 people’s experiences that were shared with us and the Healthwatch network between April 2019 and December 2020) we also looked closely at remote appointments and to understand how they are working for people. We collated our findings into our ‘GP Access during COVID-19’ report in March 2021 to help the NHS understand the full impact of the pandemic on people’s experiences of primary care and a summary of what people told us is as follows:

While the pandemic has presented new challenges for General Practice, in many ways it has just exacerbated longer-term problems and made them more apparent. This provides an important opportunity for the NHS to learn and address these problems, and to embrace the improvements brought about by new ways of offering the service. To do this, we are calling on NHS England to undertake a formal review of the ways people access General Practice to make sure the service works for everyone, and crucially, that people understand changes and how these affect the way they can get the care and support they need.

 

What are the main barriers to accessing general practice and how can these be tackled?

 

 

What are the main challenges facing general practice in the next 5 years?

 

How can the current model of general practice be improved to make it more sustainable in the long term? In particular:

Dec 2021