Relationship between the volume and type of appointments in general practice and patient experience: an observational study in England

BACKGROUND: Patient satisfaction is a significant dimension of quality in general practice and has notably declined post-COVID. Understanding the dynamics between practice activities, practice characteristics, and patient experience is vital for improving care quality.

AIM: To investigate the relationship between the volume, modality (telephone or face to face), and practitioner type of general practice appointments and patient experience.

DESIGN AND SETTING: This was an observational study of general practices in England.

METHOD: Data from the GP Patient Survey (GPPS) were merged with NHS England's practice-level appointment data, covering August 2022 to March 2023. Ordinary least squares regressions were estimated of patient satisfaction with access, general satisfaction, preference for a specific GP, and support for managing long-term conditions (dependent variables) against appointment volume, modality (telephone or face to face), and practitioner type.

RESULTS: Analysis of 5278 practices showed that a higher volume of appointments, especially face to face with GPs, was significantly (P<0.001) associated with increased patient satisfaction. Practices having a greater proportion of same-day appointments was significantly correlated with lower patient satisfaction.

CONCLUSION: Patient satisfaction and ability to have health needs met is associated with face-to-face access to GPs as well as the total volume of appointments available. The results suggest that patients' perceptions of access involve more than immediate availability of appointments or that patients may struggle to get appointments at practices offering more same-day appointments. Initiatives to improve access to, and satisfaction with, general practice should prioritise expanding face-to-face GP appointments.