LOCAL NHS leaders have “reconfirmed their commitment to improving access to general practice services” for patients in Harlow and Uttlesford with the publication of a report by Healthwatch Essex.

NHS Hertfordshire and West Essex Integrated Care Board (ICB) commissioned Healthwatch Essex to survey Harlow and Uttlesford residents to help the local NHS understand their experience of accessing general practice services and to produce a report with recommendations. 

The survey found that whilst most people said their appointments were good, many found it difficult to access services. Recommendations from Healthwatch Essex included: 

• Giving greater flexibility regarding accessing appointments: not restricting the time when patients can phone for one.
• Being aware that not everyone has digital access or skills to be able to use online or other digital services. 
• Easier ability to book future appointments for medicine reviews, blood tests, routine screening and so on.
• Improved triage systems so patients are correctly directed to the right clinician for their needs the first time they contact the practice about a particular issue.
• Increase the diversity of clinical skills for available staff in practices. 
• Improved training for frontline reception staff on communication skills and awareness of various conditions such as autism, dementia, mental health, stroke and trauma.

GP practices continue to be very busy with 85,000 appointments were delivered for the just under 200,000 patients registered in Harlow and Uttlesford in January 2023. The ICB is using the feedback and recommendations from the Healthwatch survey to help improve access to services from patients in the context of this high demand. It is already taking action to improve access to GP practice and addressing some of the areas identified in the Healthwatch Hertfordshire report. 

• The ICB has recently procured a new range of online and video consultation tools to support practices in improving access. Practices are also being offered support with standardising the layout and content of their practice website to make information more accessible to patients. 
• Since 1 October 2022, Primary Care Networks in West Essex have offered additional appointments beyond “routine” opening hours.  This has meant up to 87 extra hours per week in Uttlesford (evenings and Saturday mornings) and 98 extra hours a week in Harlow.  Appointments cover routine care, urgent appointments, vaccinations and health checks.  We continue to work closely with patients to ensure that offers of extra access meet peoples’ needs. 
• PCNs across West Essex have also received local funding to provide additional appointments in general practice, which will help us see additional patients throughout the winter period, until the end of March 2023.  In Harlow and Uttlesford this equates to over 19,000 appointments.
• Funding has been secured for £1.7m for practices to upgrade their telephone systems to increase the number of phone lines into a practice to reduce waits and provide information for patients on their queue position. Six practices across Harlow and Uttlesford have been supported in upgrading their telephony systems. Three of these have gone live and the remaining three practices are working towards this.
• An acute respiratory illness (ARI) hub was mobilised in Harlow to support general practice, A&E and 111 to manage acute illness at the beginning of the Strep A pandemic and wider respiratory illnesses as the winter progressed. This provided additional clinical capacity in the community, to support this significant increase in demand and concern amongst parents at that time and supported general practice to successfully manage this demand. The evaluation of this service will inform models going into Winter 2023
• Support with developing practice patient groups (PPGs) to give patients a greater voice in the workings of their practice. A steering group made up of patients, Healthwatch, practice managers and ICB representatives is providing learning and resources to help this.
• Extending the community pharmacy consultation scheme whereby practice staff assess patients with some minor illnesses to see if can be offered an appointment with a community pharmacist instead of a GP.  There have been over 500 GP practice referrals to community pharmacies in Harlow and Uttlesford

Dr Jane Halpin, Chief Executive of Hertfordshire and West Essex ICB, said: “Our GP practices are seeing a far higher demand for services than before the pandemic and our practice staff are working extremely hard to deliver high quality and timely care. Even so, we recognise that the high demand is leading to many local residents having difficulty accessing services and we are truly sorry for that. We are working to transform our primary care services so that we are better able to meet patients’ needs now and in the future. This means providing services in new ways such as making best use of online and digital options, investing in telephone systems and growing the support offered by community pharmacists. 

“Unfortunately, the survey showed that some respondents felt they couldn’t contact their GP practice because they were concerned about burdening the NHS, worried they wouldn’t get through or assumed they wouldn’t get an appointment. We would like to remind everyone that GP practices and other parts of the NHS are here to help. If you are concerned about an ongoing symptom please don’t hesitate to contact your GP practice, NHS111 or your local pharmacy. ”

Samantha Glover, Chief Executive of Healthwatch Essex, said: “It is great to be working alongside the ICB to make practical improvements to the services the people of West Essex receive. We know people are having challenges accessing primary care at times and it is important that we explore that in more depth to understand if there are changes that could be made which would improve their experience.  Sometimes the simplest of changes can make a huge difference. 

“We are pleased that so many people came forward to share their experiences, which helped us to form the list of recommendations that we have been able to provide to the ICB. We hope acting upon these suggestions will help to alleviate some of the common frustrations that people shared with us during the project – ultimately improving GP access for people across West Essex.  

The report is available here: https://healthwatchessex.org.uk/wp-content/uploads/2023/03/GP-access-Herts-and-West-Essex-ICS-2022.pdf

This is one of the first reports from a series of surveys that the ICB has commissioned Healthwatch to carry out in support of work to improve patient access to primary care. The ICB will use these surveys and other feedback from patient alongside any changes in national guidance to ensure we are improving GP access for residents. 

The ICB is also encouraging patients to contact the practice manager or their patient practice group to provide feedback about the service or raise a concern. Patients who are unable to resolve an issue with the practice can contact NHS England as follows: [email protected]   Telephone: 0300 311 22 33.