Improving access to primary care

The healthcare provided in the community for initial advice or treatment, is one the most critical areas of the health service for patients. Many factors can determine access to these services, including location, opening times, how easy it is to make an appointment, the overall speed of access and how likely you are to see the practitioner of your choice.

Improving access to GP services

Ensuring people have access to high quality care and support from their GP practice is a key priority for us – and practice teams continue to work incredibly hard as they continue to see more patients than ever before.

Data published by NHS England, shows the rapid increase in demand we have seen over the last few years - and just how much activity is now going through primary care. Comparing activity levels pre and post Covid, the data shows that, nationally, we are now seeing four million more GP appointments delivered every month, compared with activity levels before the pandemic.

These figures relate to face-to-face and virtual appointments and don’t capture the hundreds of online requests our practices receive each day through new online services, where Surrey has the highest level of activity in the country.

These new ways of working, and the ability to submit requests online has proved popular for many of our residents who prefer to use digital services and they are in addition to the more traditional channels, which we will always continue to offer our patients.

These new initiatives, many of which are set out in the national Primary Care Recovery Plan, signal a new way of working for practices across all parts of the country, including in Surrey Heartlands.

Following feedback from local engagement work, and having engaged with practices to understand the key challenges, a great deal of work is already underway to help make it even easier for people to access help and support. This includes expanding the primary care team and we have also worked with practices to make practical improvements to their phone systems and websites so it’s easier for patients to get in touch and get the help they need, including through the use of digital services.

Expanding practice teams

As part of a national programme, we are introducing many new roles within GP practices – including more pharmacists, paramedics, physiotherapists and many other specialist roles - that provide help and advice. This means instead of always seeing a GP, people will see the professional they need across these new expanded teams. As well as bringing additional clinical skills and new specialists into the team, meaning people can be see a wider range of professionals locally, it also helps people to be seen more quickly as part of our ‘right care, right place, first time’ principle.

We will be introducing over 530 of these additional roles at GP surgeries across Surrey Heartlands by 2024 – and 300 of them are already in place.

Improved IT and telephone systems

As part of these improvements, all 101 of our practices have now moved on to cloud telephony, which has helped deliver improvements in triage and call handling. This development has also had a positive impact on patient’s experiences, where we now have advanced phone systems that can cope with the call volumes we are now seeing.

Supporting practices as we move to a new way of working

The national Next Steps for Integrating Primary Care: Fuller Stocktake Report set out a need to transform the design and delivery of health and care services to bring services together, ensure people can access the care they need easily and provide greater continuity of care, which we know is important for many people.

As practices continue to see more patients than ever before – with around 19,000 appointments every day across our GP practices – we need to support our practices as we embark on this journey.

We know practices can vary significantly in terms of their patient list size, their geography and the population they serve so rather than take a ‘one size fits all approach’ we are working with practices individually to understand the challenges they experience, and the feedback they receive from patients, and work with them to identify areas for change.

Building on the work we have already undertaken, we are now focusing on two key areas that local communities have told us matter most to them:

  • making it easier to access care patients need, when they need it
  • creating the space and time for clinicians to provide the continuity of care that is so important to patients

To help achieve this, we have created a GP Development Toolkit which has been designed to support practices through this journey, providing insight, data and practical support to help practices address the areas that are important to them and their patients.

The toolkit comes with the support of our primary care team, who are working with Primary Care Networks and practices to identify opportunities and implement changes so practices can grow and evolve in a way that benefits both patients and practice staff.

Emphasising access to general practice while developing other services

We will continue to emphasise access to general practice while developing other primary care services. Innovations generated during the pandemic are coming together to improve services and patient experience.

To support this, we will:

  • Use patient experience and GP survey results and work with stakeholders to co-design service access improvements.
  • Revise and expand patient communications to reach people who find services hard to reach.
  • Grow our multi-disciplinary teams to include roles such as social prescribers and care coordinators to support individuals with the ‘wider determinants of health’ and create ever more flexible health and care support.
  • Increase use of GP community pharmacy consultation service to help people access a same-day appointment for minor illnesses or an urgent supply of regular medicine.
  • Use our ‘delegated commissioning’ to incorporate Pharmacy, Optometry & Dentistry into local primary care services to join up care, and increase focus on prevention and early intervention enabling the proper care at the right time and in the right place.


Primary Care Networks 

Practices have come together to support the stability of general practice and work together to employ additional roles and start to deliver services such as extended access and the Covid-19 vaccinations. Now that primary care networks have matured, we will support them to take up further opportunities together.