“Loops and hurdles”: secondary analysis of patient interview data to explore the experience of patient access to UK general practice

BACKGROUND: Many countries are experiencing a shortage of general practitioners, increased demand for primary care, resulting in difficulties for patients seeking access and leading to increased dissatisfaction. The NHS Delivery Plan for Recovering Access to Primary Care in May 2023 signalled a UK policy commitment to improve GP access. METHODS: To explore patients' experience of access to UK general practice as reported in previously conducted interview studies of COVID and non-COVID related conditions a secondary analysis of interviews with 286 participants from five qualitative interview studies originally carried out between 2020 and 2023 was conducted. Qualitative thematic secondary analysis using a mix of deductive and inductive coding was used to examine interview data about patients' experiences of health conditions and health services. RESULTS: The interview data reveal 'loops' and 'hurdles' experienced by patients which delay and complicate the process of accessing general practice. Obstacles to access included needing to phone back several times, using online triage systems and negotiating with receptionists. Some patients were able to develop strategies or had resources including time and knowledge of the health system that helped them overcome access barriers, but the overall picture is of difficult and often negative access experiences. CONCLUSION: Secondary analysis of archived health experience interview data can provide additional evidence about access to care. Policy and practice solutions to access challenges increasingly rely on the use of phone and online systems of triage and for appointment making but these can increase delays and are experienced as significant barriers to access, fuelling dissatisfaction with primary care.