Patients say that they are finding it more difficult to get an appointment with their general practice. This study will assess whether patients were more of less likely to receive an appointment in 2022 compared with earlier years. The likelihood that a patient will receive an appointment will depend to some extent on how unwell they are. We will take account of this, so that we can compare a patient's chance of getting a GP appointment over time, in a fair manner.
Understanding the changes in the chances of getting a GP appointment over time, will help the NHS to estimate how many additional GPs and practice staff might be required, which areas need the most additional support, and what else can be done to make GP services more accessible.
The study will estimate consultation rates in England by year between 1995 and 2022, having adjusted for registered patients' age, sex, morbidity and deprivation of area of residence.
Study population: a random sample of 560,000 patients from the May 2023 CPRD Gold denominator data, and 560,000 patients from the March 2023 CPRD Aurum denominator data.
Primary outcome: general practice consultations
Exposure: time registered with GP practice
Covariates: single-year-of-age, sex, deprivation quintile (IMD 2019), Cambridge Multimortibidy Score (GP consultation weighted version) grouped into 5 ordered segments, and year of consultation.
Data sources: Data on patients outcomes, exposure, and covariates will be extracted from CPRD. Data on patients IMD 2019 quintile will be derived from the Small Area linked data. This data will be assembled into a data-frame grouped by each levels of the covariates, and summing the outcomes and exposures.
Study-design and method: We will use negative-binomial regression to estimate the relationship between consultation rates and our covariates, having taken account of the extent of exposure. Will will consider the use general additive models (GAMs) to account for the non-linear relationship between age and our outcome. Separate GAMs will be fitted for male and female patients.
Public benefits of the research: The research will provide policy makers with information about the extent to which GP consultation rates have kept pace with changes in registered patients needs, and whether consultations are distributed over Integrated Care Boards in line with patient's needs.
all general practice consultations; face-to-face consultations; remote (telephone/video) consultations; home visits; consultations delivered by GPs; consultations delivered by other general practice staff
Steven Wyatt - Chief Investigator - NHS MIDLANDS AND LANCASHIRE COMMISSIONING SUPPORT UNIT
Steven Wyatt - Corresponding Applicant - NHS MIDLANDS AND LANCASHIRE COMMISSIONING SUPPORT UNIT
Mohammed Amin Mohammed - Collaborator - NHS MIDLANDS AND LANCASHIRE COMMISSIONING SUPPORT UNIT
Paul Seamer - Collaborator - The Strategy Unit
Simon Bourne - Collaborator - The Strategy Unit
Patient Level Index of Multiple Deprivation