Exploring the impact of the national extended access scheme on patient experience of and satisfaction with general practice: an observational study using the English GP Patient Survey

Abstract

Background: Extended access services were introduced to help stop declining patient satisfaction with access to general practice. There has been no evaluation, at a practice population level, as to how the introduction of these services has impacted patients. Aim: To explore the association between practices offering extended access and patient responses to the GP Patient Survey (GPPS). Design & setting: An observational study was carried out. Patient experience data were taken from the national GPPS in England (2018 and 2019). Data on the provision of extended access services were sourced from NHS England. The analyses considered potential confounding factors. These were sourced from publicly available data about practice characteristics from NHS Digital, NHS England, and government websites. Method: The percentage of patients reporting positive responses to questions related to satisfaction with access, continuity of care, and overall satisfaction were modelled. The association between these outcomes and the provision of extended access were estimated via multivariable fixed-effects linear regression. Results: There were no associations between practices offering extended access services and key indicators of patient experience or satisfaction at a practice population level. Conclusion: Extended access has a cost of an estimated 250 million GBP per year. While there is a body of work that finds associations with emergency department use reduction, at a practice population level, in this study it has been found that extended access had no measurable impact. This may be because extended access services are only used by a small number of patients, and its introduction has not significantly impacted general practices and most general practice patients.