The purpose of this project was to examine the literature around patient access to FCPPs, investigate access routes according to FCPPs, and explore patient experiences of accessing FCPPs.
A scoping review of the literature, a national survey of FCPPs regarding how patients access their care, and a qualitative interview study using thematic analysis with patients about their experiences of accessing FCPP appointments were performed.
Scoping review: Twenty-four studies included, consisting of sixteen published articles/abstracts and eight grey literature materials, such as guidance documents and online discussions. Very little evidence or detail in the literature regarding how patients access FCPPs; nine had just a single line mentioning access. From the minimal detail that exists, the role of GP Receptionists in ‘signposting’ patients to FCPP appointments is key.
Survey: There were 193 respondents from all areas of the UK. The most common route into an FCPP appointment was booking via reception, closely followed by booking after seeing another clinician for the problem. Patient and staff awareness/understanding of the FCPP role, use of triage systems, and Receptionists’ role in care navigation were all important elements for efficient access to FCPPs.
Interview study: Thirteen participants who had accessed FCPP appointments were interviewed. Awareness of FCPP was generally low amongst participants prior to their appointment and five had seen a GP before the FCPP. Facilitators included quick and simple access routes to FCPP. Barriers included difficulty contacting GP surgeries and public perception of needing to see a GP initially. The likelihood of accessing FCPP again was low when patients had a disappointing first experience of care.
Access routes to FCPPs and patient access preferences are variable. FCPPs are often a second contact, which can negatively impact efficiency and patient experience. GP staff and patient awareness and understanding of the FCPP role is likely to improve access. These studies provide new and important evidence about how patients access FCPP appointments, challenges in access and improvements required. Future work should explore how to implement these improvements to ensure best use of health care resources.
It is clear from these three studies that communication is vital to optimise the use of FCPPs; communication to patients about the role, and communication between GP staff and FCPPs to ensure that the right patients see the right clinician at the right time. As FCPP provision expands in General Practice it is important that those who implement FCPP services consider the findings of this work to ensure that access to FCPPs is efficient and equitable for all.
Musculoskeletal
Primary Care
