New research highlights wide variation in access to GP surgeries across Scotland

A new research paper by Reform Scotland, the independent, non-party think tank, has shown that only two-thirds of the nearly 1,000 GP surgeries in Scotland have a website, and that less than 10% allow appointments to be booked online.

Examining Access: Survey of GP practices in Scotland used research carried out this summer and revealed that, of the 994 GP surgeries in Scotland:

• Only 670, or 67%, have a website
• Just over half (511 surgeries) offer the ability to order repeat prescriptions online
• Less than two-fifths (389 surgeries) advertise extended opening hours online
• Only 10% of surgeries allow online appointment bookings

96% of GP surgeries are private contractors, but of Scotland’s 42 practices directly funded by the NHS, the statistics are even poorer. Less than one-third have a website, and not a single directly-funded practice allows online appointment bookings.

This is all despite a report developed by the Royal College of General Practitioners and the Scottish Government in 2010 suggesting that improvements in access could be made by adopting such practices.

Research also highlighted a wide variation in availability of appointments with some practices only offering appointments on the day, while others allowed appointments to be booked up to 6 weeks in advance.

Commenting, Reform Scotland’s Director Geoff Mawdsley said:

“This report is not about the medical care provided by individual doctors or GP practices, but about the practical arrangements as to how patients access their GPs, the “gate-keepers” to our health service, and whether we can’t improve arrangements to encourage a better provision of service.

“Surveys such as the Scottish Government’s Health and Care Experience Survey tend to suggest that while the public often praise the care they receive, there can be frustrations with the difficulty in accessing that care to begin with.

“Reform Scotland believes that it is simply unacceptable that there is such a wide variation in the way people can access GP services across Scotland, a variation that has nothing to do with the size or geography of the area covered by different practices.

“We were surprised that in 2014 just 67% of GP practices have a website and only just over half allowed you to order a repeat prescription online or by email. The results are particularly disappointing considering that the Royal College of General Practitioners, in partnership with the Scottish Government, developed a toolkit in 2010 highlighting the usefulness of the internet in the development of GP service.

“Reform Scotland believes that giving individuals greater choice over their GP practice would mean that people were able to easily walk away from GP practices they felt did not provide services that suited them. We don’t envisage that such a policy would lead to a mass exodus of patients from GP practices, but the potential that they could would give them much greater influence over the way services developed.”

In addition to its recommendations on giving patients more choice over their GP practice, the Reform Scotland report recommended:

• the provision of more, and clearer, information to patients about GP services. Even without introducing the recommendations in this report, some patients do have a limited choice over their GP, but that choice is pointless if they are unable to find out what they can choose between. We were disappointed that there is such a difference in the quantity and quality of the information provided by NHS Choices in England compared to NHS 24 in Scotland with regard to finding our about local GP practices.  We believe that NHS 24 should aspire to provide at least as good a range of information about local services as its counterpart in England.
• that new GP surgeries be permitted to open up. Despite being private businesses, existing GP surgeries are effectively protected from competition at the discretion of NHS boards. By allowing new practices to open, the NHS could ensure that patients have greater choice and that the increased competition would improve the access and service arrangements offered to patients.
• to end the ban on private companies opening GP practices. 96% of GP practices are private businesses, operating as partnerships. However, there is a ban in place on private companies (i.e. limited companies) opening surgeries. This should end – it is illogical and inconsistent that the government should decide that some private enterprises are acceptable but others are not.
• that GP surgeries publish annual accounts. A Freedom of Information request to the Scottish Government indicated that GP practices were not under any obligation to provide information to their Health Board or any other organisation outlining how they spent the public money they received. Reform Scotland believes that all private enterprises receiving public money to provide a public service should be transparent and accountable, and therefore publish annual accounts