“We showed that some of the people who tend to use primary care services more often (e.g. retired people and people over 65 years) are more likely to choose to stay with a practice inside their neighbourhood than go outside. If it was confirmed that healthier groups (who use fewer services) were more interested in convenient GP practices outside their local neighbourhood and, e.g., closer to their workplace, this could raise complex issues in terms of equity of access to services and imbalances in the case-mix of practice lists, putting increased pressure on the fairness of the weighting for patient need that underlies the per patient practice capitation payment in the NHS General Medical Services contract.
Another important finding of the study relates to the hierarchy in preferences for different ways of making GP practices more convenient and accessible. We found that all respondents viewed the speed at which they could be seen by their GP as the most crucial aspect, followed by having a practice with extended opening hours. By contrast, opening a GP practice at weekends had only a marginal impact on registration choices, which suggests there would be more benefit from extended opening hours during the week than at weekends. Assuming that demand for GP services is constant, a policy encouraging practices to extend their opening hours Monday to Friday is likely to decrease the average patient waiting time for an appointment. In that case, this could be preferable to other ways of improving GP access, especially weekend opening, whose likely additional cost seems likely to exceed any added benefit from the patient’s point of view.”
Continuity of care and A+E