GP Report 2020: Patients’ experiences of Primary Care in Brighton and Hove

Findings 

Overall patient feedback

• 89% of patients rated the overall quality of care communication as good or very good, by either their GP or nurse combined, on seven criteria.
• • Patient satisfaction with their GP Practice was also generally good. We assessed GP Practices using seven criteria of satisfaction and on average 70% of patients rated five from the seven criteria as good or very good.

GP Capacity

• Patient caseloads have increased from 2,394 patients per doctor in 2017/18 to 2,479 in 2018/2019. This is against an England average of 1,825 per doctor.
• The number of GP Practices has decreased from 48 to 35 from 2015 to 2019. There are also currently five branch surgeries that provide GP services. Two GP Practices have closed since our last report in 2018 and a further closure/merger is planned for early 2020. This undoubtedly affects ease of accessibility, especially for patients with mobility challenges.

Accessibility

• Booking by telephone is popular but not always easy to use: 92% of patients book an appointment by telephone but only 68% of patients find booking this way to be easy. This mostly affects those less able to visit the GP Practice in person and/or those less likely to use online booking systems. 
• Urgent GP appointments are not guaranteed: 81% of GP Practices could not guarantee same day booking for urgent appointments.
• Choice of GP is not guaranteed: 29% of patients who wanted a choice of GP, were unable to achieve this. This mostly affects patients with long-term health conditions including mental health issues, where consistency of care is important.

Personalised Care

• There is a low awareness of preventative services. Of patients who should be targeted for preventative services, 37% are unaware of health checks for 40-74 year olds; 44% are unaware of abdominal aortic aneurysm screening; 25% are unaware of bowel cancer screening; and 53% are unaware of annual health checks for people with long-term health conditions.
•  70% of people referred to an NHS service with a mental or emotional health problem, felt not all their needs had been met or their needs had only been partially met.  
• In addition, patients with long-term health conditions, including mental health, spoke to us about needing consistency of care. Patients wanted longer appointments, to allow complex conditions to be treated in full and to allow the diagnosis of more than one condition. Patients asked for medical staff that specialise in their condition.

Key Recommendations pertinent to the current environment of restore and recovery are:

 Digital / Remote Consultations: Greater use of digital methods to improve making appointments and broadening the range of ways in which consultations are provided.

• Preventative Services: Raising awareness of preventative services, targeting patients who are most likely to need these services.

• Preventative Services: Better patient access to GPs specialising in their condition, particularly where it is long-term, for example mental health issues.

• Primary care system sustainability: Our GP Report presents the context for all of the above, of persistently high numbers of patients per GP coupled with the number of GP practices having decreased since our report in 2018