Evidence for access: systematic scoping review of access systems in general practice
Evidence for access: systematic scoping review of access systems in general practice
Background: access to GP appointments is increasingly challenging in many high-income countries, with an overstretched workforce and rising demand. Various access systems have been developed and evaluated internationally.
Aim: we aimed to systematically consolidate the current international evidence base related to different types of GP access systems.
Design and setting: a scoping review examining international literature.
Method: literature searches were run across relevant databases in May 2022. Title, abstract and full text screenings were carried out. Data from included studies were extracted and mapped to synthesise the components and aims within different GP access systems.
Results: 49 studies were included in the review. The majority of these were set in the UK. Some access systems featured heavily in the literature, such as Advanced Access, telephone triage and online consultations, and others less so. There were two key strategies adopted by systems which related to either changing appointment capacity or modifying patient pathways. Components related to these strategies are summarised and illustrated as a schematic representation. Most rationales behind access systems were practice, rather than patient, focused. 'Add on' systems and aims for efficiency became more popular in recent years.
Conclusion: the synthesis provides a useful tool in understanding access systems' aims, design, and implementation. With focus on alleviating demand, patient-focused outcomes appear to be under investigated and potentially overlooked during design and implementation. More recently, digital services are promoted as offering patient choice and convenience. But a context where demand outweighs resources challenges the premise that extending choice is possible.
primary care
Eccles, Abi
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Bryce, Carol
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Driessen, Annelieke
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Pope, Catherine
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MacLellan, Jennifer
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Gronlund, Toto Anne Christine
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Nicholson, Brian D
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Ziebland, Sue
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Atherton, Helen
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Eccles, Abi
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Bryce, Carol
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Driessen, Annelieke
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Pope, Catherine
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MacLellan, Jennifer
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Gronlund, Toto Anne Christine
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Nicholson, Brian D
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Ziebland, Sue
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Atherton, Helen
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Eccles, Abi, Bryce, Carol, Driessen, Annelieke, Pope, Catherine, MacLellan, Jennifer, Gronlund, Toto Anne Christine, Nicholson, Brian D, Ziebland, Sue and Atherton, Helen
(2024)
Evidence for access: systematic scoping review of access systems in general practice.
The British journal of general practice : the journal of the Royal College of General Practitioners.
(doi:10.3399/BJGP.2023.0149).
Abstract
Background: access to GP appointments is increasingly challenging in many high-income countries, with an overstretched workforce and rising demand. Various access systems have been developed and evaluated internationally.
Aim: we aimed to systematically consolidate the current international evidence base related to different types of GP access systems.
Design and setting: a scoping review examining international literature.
Method: literature searches were run across relevant databases in May 2022. Title, abstract and full text screenings were carried out. Data from included studies were extracted and mapped to synthesise the components and aims within different GP access systems.
Results: 49 studies were included in the review. The majority of these were set in the UK. Some access systems featured heavily in the literature, such as Advanced Access, telephone triage and online consultations, and others less so. There were two key strategies adopted by systems which related to either changing appointment capacity or modifying patient pathways. Components related to these strategies are summarised and illustrated as a schematic representation. Most rationales behind access systems were practice, rather than patient, focused. 'Add on' systems and aims for efficiency became more popular in recent years.
Conclusion: the synthesis provides a useful tool in understanding access systems' aims, design, and implementation. With focus on alleviating demand, patient-focused outcomes appear to be under investigated and potentially overlooked during design and implementation. More recently, digital services are promoted as offering patient choice and convenience. But a context where demand outweighs resources challenges the premise that extending choice is possible.
Text
BJGP.2023.0149.full
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Accepted/In Press date: 11 December 2023
e-pub ahead of print date: 19 January 2024
Additional Information:
Copyright © 2024, The Authors.
Keywords:
primary care
Identifiers
Local EPrints ID: 487266
URI: http://eprints.soton.ac.uk/id/eprint/487266
ISSN: 0960-1643
PURE UUID: 88159198-1f9c-4902-8225-922f42386877
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Date deposited: 16 Feb 2024 17:15
Last modified: 10 Apr 2024 02:14
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Contributors
Author:
Abi Eccles
Author:
Carol Bryce
Author:
Annelieke Driessen
Author:
Catherine Pope
Author:
Jennifer MacLellan
Author:
Toto Anne Christine Gronlund
Author:
Brian D Nicholson
Author:
Sue Ziebland
Author:
Helen Atherton
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