Fund looks to tech to assess access

A think tank has suggested that two technology-based initiatives could be included in a raft of measures to assess the quality of access to general practice.

The King’s Fund has argued that opportunity to book appointments online and to communicate with GPs and practice staff by email could be used as access indicators.

In a paper published this week as part of its 18 month inquiry into the quality of general practice, the Fund suggests 20 additional measures that could be used.

These include list size per GP, whether a practice is open or closed to new registrations, and proportion of people satisfied with opening hours.

The researchers said “most people, most of the time” report good access to general practice but there were variations between practices and between primary care trusts.

Variations covered everything from the number of GPs per 100,000 patients – a figure which was less than 50 in some PCTs and more than 80 in one case – to the ability to speak to a GP on the telephone.

Only 25% of patients in the research for the report said that this was very or fairly easy to do so.

Although the report suggests that online appointment booking and communication via email could be used as access indicators, they admit there is no existing source of information to measure them.

Other proposed measures include the ability to get through on the telephone and speak to practice staff and GPs. Both of these are currently measured by the GP Patient Access Survey.

The researchers add that the measures should not be applied in a ‘one size fits all’ way, and that changes in technology, the impact of changing patient expectations and increasing financial pressures are likely to affect how good quality access is assessed in future.

The report says that “to an extent” NHS Direct, NHS Choices and walk-in centres had already changed the relationship between patients and the NHS and provided alternative ports of call.

It adds: “Detailed access metrics will need regular revision, and much broader and less specific measures may eventually be adopted as services, preferences and technologies change.”

The report on access is one of several commissioned by the King’s Fund as part of its inquiry into genera practice, which is due to report in late 2010.

The King’s Fund said that as well as making a judgement about current care quality, the final report of the inquiry will examine how data and information in general practice can be better used to measure good practice and enable quality improvement.