Does Advanced Access improve access to primary health care? Questionnaire survey of patients.
BACKGROUND
General practices in England have been encouraged to introduce Advanced Access, but there is no robust evidence that this is associated with improved access in ways that matter to patients.


OBJECTIVE
To compare priorities and experiences of patients consulting in practices which do or do not operate Advanced Access.


METHODS
Patient questionnaire survey.


METHODS
Forty-seven practices in 12 primary care trust areas of England.


METHODS
Questionnaire administered when patients consulted.


RESULTS
Of 12,825 eligible patients, 10,821 (84%) responded. Most (70%) were consulting about a problem they had had for at least 'a few weeks'. Patients obtained their current appointment sooner in Advanced Access practices, but were less likely to have been able to book in advance. They could usually see a doctor more quickly than those in control practices, but were no more satisfied overall with the appointment system. The top priority for patients was to be seen on a day of choice rather than to be seen quickly, but different patient groups had different priorities. Patients in Advanced Access practices were no more or less likely to obtain an appointment that matched their priorities than those in control practices. Patients in both types of practice experienced problems making contact by telephone.


CONCLUSIONS
Patients are seen more quickly in Advanced Access practices, but speed of access is less important to patients than choice of appointment; this may be because most consultations are about long-standing problems. Appointment systems need to be flexible to accommodate the different needs of different patient groups.
Salisbury
Chris
C
Academic Unit of Primary Health Care, Department of Community Based Medicine, University of Bristol, Bristol. c.salisbury@bristol.ac.uk
Goodall
Stephen
S
Montgomery
Alan A
AA
Pickin
D Mark
DM
Edwards
Sarah
S
Sampson
Fiona
F
Simons
Lucy
L
Lattimer
Val
V
D001071:Appointments and Schedules; D016022:Case-Control Studies; D004739:England; D005194:Family Practice / Q000458:organization & administration* / Q000592:standards; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires
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