Access targets 'sideline older and sicker patients', study finds
By Nigel Praities
The Government's drive to extend practice opening hours ignores the needs of older and sicker patients, new research concludes.
The study found older patients and those with long-term conditions were much less concerned with longer opening hours and keener to see their usual GP.
The survey of 140 patients from a practice in Newmarket, Suffolk found older patients were 15 times less likely to accept a same-day appointment with a doctor they did not know and would prefer to wait for their usual doctor, compared with younger patients.
Those with chronic conditions were more than three times less likely to accept a same day appointment rather than wait for an appointment with their usual doctor, compared with those with acute conditions.
The unpublished study raises questions over Government priorities which seek to improve access over continuity of care in general practice.
Lara Stewart, study author and a medical student in her second clinical year at the University of Cambridge, said the study showed the importance of patients having access to a named doctor.
‘From more informal chats with patients, lots of them were saying it was really important that the doctor knew them and their whole family. That is more important than the Government takes into account,' she said.
Professor Chris Salisbury, professor of primary care at the University of Bristol, said the study added to a growing evidence base on the importance of continuity of care.
‘Policy needs to take more account of what people want, particularly those who most need and use health care such as the elderly and those with chronic conditions. Access is important but so is continuity,' he said.
A recent study published in the New England Journal of Medicine showed a sharp drop in continuity of care since the introduction of the new GMS contract in 2004.
Professor Martin Roland, one of the authors of the NEJM study and professor of health services research at the University of Cambridge, said he would welcome a greater focus on continuity of care from the Government.
‘It is something that is important for patients, particularly for those with long-term conditions who are becoming a more important part of practice.
‘So I think it is very important that attention is given to finding ways in which we can provide continuity of care for those patients who want it,' he said.Older patients and those with long-term conditions were much less concerned with longer opening hours, the study found Older patients and those with long-term conditions were much less concerned with longer opening hours, the study found