Abstract
BackgroundThe administrative and professional consequences of access targets for general practices, as detailed in the new GMS contract, are unknown. This study researched the effect of implementing the access targets of the new GP contract on general practice appointment systems, and practice manager satisfaction in a UK primary health care setting.MethodsA four-part postal questionnaire was administered. The questionnaire was modified from previously validated questionnaires and the findings compared with data obtained from the Western Health and Social Services Board (WHSSB) in N Ireland. Practice managers from the 59 general practices in the WHSSB responded to the questionnaire.ResultsThere was a 94.9% response rate. Practice managers were generally satisfied with the introduction of access targets for patients. Some 57.1% of responding practices, most in deprived areas (Odds ratio 3.13 -95% CI 1.01 – 9.80, p = 0.0256) had modified their appointment systems. Less booking flexibility was reported among group practices (p = 0.006), urban practices (p < 0.001) and those with above average patient list sizes (p < 0.001). Receptionists had not received training in patient appointment management in a quarter of practices. Practices with smaller list sizes were more likely than larger ones to utilise nurses in seeing extra patients (p = 0.007) or to undertake triage procedures (p = 0.062).ConclusionThe findings demonstrated the ability of general practices within the WHSSB to adjust to a demanding component of the new GP contract. Issues relating to the flexibility of patient appointment booking systems, receptionists' training and the development of the primary care nursing role were highlighted by the study.
Highlights
The administrative and professional consequences of access targets for general practices, as detailed in the new GMS contract, are unknown
The aim of this study was to survey practice managers in the Western Health and Social Services Board (WHSSB) area and to examine what effect, if any, the Access Target (AT) was having on the management of patient appointments, and on practice staff, by assessing practice manager satisfaction with the scheme
Practices used a variety of appointment systems to manage patient access
Summary
The administrative and professional consequences of access targets for general practices, as detailed in the new GMS contract, are unknown. An Access Target (AT) was outlined for United Kingdom general practice, in the new general practitioner contract between practices and Health Boards [2] and linked to an enhanced service payment if achieved. This AT came into effect on the 1st of April 2004 and stated that "by 2004, all patients will be able to see a primary care professional within 24 hours and a GP within 48 hours". Practices were required to provide evidence to the relevant Health Board [3] that they were meeting this standard, following which they would receive a payment Payments for meeting this access standard have since been reviewed [4]
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