Improving Access to General Practices

INTRODUCTION TO
RESEARCH

Table of Contents
ABSTRACT ....................................................................................................................................1
INTRODUCTION...........................................................................................................................2
Research Project Title- Improving Access to General Practice.......................................................2
Research Problem............................................................................................................................2
Research Aim and Objectives..........................................................................................................3
LITERATURE REVIEW................................................................................................................3
The main nationwide complaints regarding GP access.........................................................3
Gain insight into the day-to-day problems that are being experienced by the patients to access
GP...........................................................................................................................................4
Changes that are required at daily running of GP practices (at a managerial level), to widen
the access for patients by together enhancing their overall experience..................................5
Research Methodologies..................................................................................................................5
Finding.............................................................................................................................................7
Discussion & Recommendation.....................................................................................................13
ACKNOWLEDGEMENTS ..........................................................................................................15
REFERENCES..............................................................................................................................16
APPENDIX ...................................................................................................................................17

ABSTRACT
The work or task of practitioners which is based on the community or society who
provides treatment to people with minor or major illness is known as general practice. The
practitioners who are giving general practice treats all the common medical conditions as well as
refer patients to hospitals and other medical services for urgent and specialist treatment. The
complete health of patients including physical, social and psychological aspects of case focused
by these practitioners. Researcher has used methods of research are research approach, data
collection, sampling, data analysis and ethical consideration. Data has collected from 10
employees. General practices in health care sector which treats all common medical conditions
and refer patients to hospital and other medical services for urgent and specialist treatments at
urgent care centre (UCC). In order to recommended strategies for general practices through
which health care sector can easily maintain proper quality and safety strategies needs.
1

INTRODUCTION
The work or task of practitioners which is based on the community or society who
provides treatment to people with minor or major illness is known as general practice. The main
purpose of this research is to reduce the urgent care centre (UCC) attendance within the general
practice business core hours which is 8:00- 6:30 Monday to Friday which affecting the quality of
care they are proving. In this present research, National Health Services (NHS) organisation is
chosen for study the research. This project will discuss the research title, problems. This research
will also frame researcher aim and objectives. Research methodologies will also be used to
identify the major in providing health service to the patients as well as proving effective
recommendation in improving the quality of services.
Research Project Title- Improving Access to General Practice.
General practice is the work of doctor that is based in the community who treats patients
with minor or chronic illness and refers those with the serious conditions to a hospital. The
practitioners who are giving general practice treats all the common medical conditions as well as
refer patients to hospitals and other medical services for urgent and specialist treatment. The
complete health of patients including physical, social and psychological aspects of case focused
by these practitioners (Burwell, 2015). It is very emerging topic in United Kingdom as people
are facing many issues regarding the general practices and this is the reason of the selection of
the topic. The role played by general practitioners are very essential as people living in societies
are depended on them. They play a vital role in promoting, preventing as well as initiating
treatment of people. In United Kingdom there are more than 1.3 million general practice
consultations each day, mots of which takes place in GP surgery or within the family of patients.
In UK, the working hours of General Practice doctors at urgent care centre (UCC) are very long
and they are facing the issues of work load which in turn affecting quality services of the
practitioners. The patients are not satisfied with the general practitioners of UK.
Research Problem
It is far-flung study that people are finding it more difficult to access there general
practice. The practitioners are growing pressure as an upshot of an increase in the volume as well
as intensity of there work. It has been monolithic increase in demand for the services. Similarly,
less General practice are choosing to undertake full-time clinical work in general practice
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whereas huge number of people are retiring as well as leaving the profession (Coulter and et.al.,
2014). The most common complaint regarding general practise is about the access. An
inaccessible system of primary care will necessarily outcome in patients health being amused to
emergency services and out of hour care centres, causing more strain on a pool of limited
resource. Practitioners are managing critical cases as well as proving services to patients but still
it is not appropriate as patients are not satisfied. An investigation of primary care related to
accessibility, effectiveness as well as continuity is essential to maintain high levels of patient
satisfaction.
Research Aim and Objectives
Aim- “ To assess the ways of improving access to General Practice by reducing their urgent care
centre (UCC) attendance”. A study on National health Service (NHS) organisation.
Objectives
 To study the main nationwide complaints regarding GP access.
 To gain insight into the day-to-day problems that are being experienced by the patients
to access GP.
 To critically analyse the changes that are required at daily running of GP practices (at a
managerial level), to widen the access for patients by together enhancing their overall
experience.
LITERATURE REVIEW
The main nationwide complaints regarding GP access.
According to Andersen, Davidson and Baumeister, (2014) the competition is also raising
among the general practices. General practice is the work of doctor that is based in the
community who treats patients with minor or chronic illness and refers those with the serious
conditions to a hospital. It has been identified that General practices are falling short of what is
needed by both The Complain Regulations 2009. This complain is made to improve the quality
of services by taking strict actions. The main national wide complain regarding the General
practices access as services they are providing in UK is not satisfying the needs as well as they
are providing quality services because of heavy work load and long timing issues. This is the
main issues and complain regarding the access to general practices. Author said that Bibbins-
Domingo, (2016) the complains are day to day increasing because of increasing the expectations
of quality as well as transparency in health care from patients. It is managing raising complexes
3

cases within the society but similarly the demand of people on health service is also changing.
Patients complain of trouble in managing to make appointments, practitioners of General
practices as well as complain of low morale and politicians complain that surgeries are not open
for long enough. Furthermore, demand for an evermore-accessible GP keeps expanding as the
population continues to grow and patients live longer with more complex needs.
Gain insight into the day-to-day problems that are being experienced by the patients to access
GP.
According to the Betancourt, (2016) Healthcare industry is mots important industry of
any economy or country. General practices is one of the most important part in healthcare
industry. Patients are experiencing troubles to access general practices in emergency time as well
as they are also facing difficulties in accessing quality of services. In addition to this, the
practitioners or doctors of general practices are responsible for providing good quality care for a
range of high prevalences chronic disease at the same time by providing continuity of care. It has
been reported that more than 75% of people or patients does not able to meet optimal standard of
services. There are various reason why patients are facing issues and difficulties in accessing
quality of healthcare because of lack of resources, fund, limited engagement, lack of information
and many other and all these affects the quality of care. Author stated that Gillies, Kinahan and
Hricak, (2015) Apart from this, not only patients, doctors are also facing challenges and issues in
providing treatment to patients such as long timing and stress of work and it affecting the
services in quality of services. Furthermore, because of long timing or work load and any other
issues of practitioners in GP are also affecting their health as well as their lives of people. They
are not taking proper medicines and drugs which also affecting the health of patients as they are
not recovering fast and possible. As per the Pecora and et.al., (2017) they are not accessing cost-
effective care which is also one of the issues that they are experiencing. 85% of patients are been
able to get an appointment on their previous attempt; two years previously this number was 87%
according to the survey. Furthermore, The very popular ongoing issues, like trouble in booking
appointments, appointment systems increases the frustration, rushed appointments, lack of
choice of GP, inadequate information for people to steer the systems of health as well as
insufficient information about out-of hours service. Thus, a good and better access is when
patients can easily and quickly get appointments they required.
4

Changes that are required at daily running of GP practices (at a managerial level), to widen the
access for patients by together enhancing their overall experience.
According to Mackey and Gass, (2015) General practices is very important part of
healthcare industry. Thus, it is very important to solve the issues in General practices which are
affecting the heath as well as life of patients. Good access of GP is when a person can reach and
obtain the services 24 hours. Changes should be implemented so that people or patients can be
satisfied with the services they are offering. Department of health in UK introduced that a policy
and strategies to address quality of accessibility as well as guarantee access within 48 hours as
they introduce the framework of Quality and Outcomes in 2004 which focus and established a
system of providing services in out of hours. Healthcare organisations have started to implement
changes so that patients can accesses to GP whenever they needed as they introduce some other
systems of provision like walk-in centres, helplines so that any person who urgently need or
required treatments. Burwell, (2015) said that, healthcare organisations has also extended the
hours of opening, developed new practices in all areas where people are getting low and fewer
services and care. The healthcare organisations faces the problem funding in projects £70
billion. Primary care plays a key role in assisting to cut down this gap by giving extra
personalised, accessible society based services for patients to improve society health and reduce
avoidable pressures on hospital resources. This will affect changing the manner of care which is
provided and precedence the services that need and want of patients within the accessible
resources and fund. Addition to this, healthcare organisations should increase workforce so that
day-to-day problems that are being experienced by the patients to access GP easily and quickly.
Research Methodologies
Research methodology is the systematic, theoretical analysis of methods that are applied
to investigate the study. This is the proper plan for conducting the research. Here are the methods
which are used by the researcher to assess the ways of improving access to General Practice by
reducing their urgent care centre (UCC) attendance.
Research Approach- It is the overall design which is used by the researcher to study the
specific topic. It is the systematic plan as well as process that span the steps from broad
assumption to explore the methods of data collection and interpretation. Several decisions and
there need to make the sense of report are included in research approach. The entire study
presented with the help of research approach. There are two types of research approach which
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are qualitative and quantitative. In this present research researcher has used both qualitative and
quantitative approach to study the problem of research and to identify the ways of improving
access to General Practice by reducing their urgent care centre attendance (UCC) (Mackey and
Gass, 2015). With the help of quantitative research, researcher has used to explore as well as
understand the main problem of research. Whereas, quantitative research approach is used in
order to test the objectives of theories by determining the relationship among the variables.
Data Collection- This is the vital part of research methodology. It is the process of
gathering as well as measuring the data or information on variable of interest in a well-defined
manner to find the answer of the research. There are tow methods of collecting data which are
primary and secondary. Primary methods of collecting data included the data which are collected
by the researcher by his/her own efforts such as survey, questionnaire, interview while secondary
collection of data includes collection of data from other sources such as books, journals, internet
articles etc. Primary data is unused and fresh data whereas secondary data is used and second
hand data. Integrity of the research cannot able to maintain without collection of data. The
reliability is much more in primary data as compare to secondary sources. The accuracy is also
high in collection of primary collection of data as compare to secondary data. The nature of
primary collection methods in original but secondary has duplicate in nature. In this present
research, researcher has collected from both the sources and identified ways of improving access
to General Practice by reducing their urgent care centre (UCC) attendance with the help of
internet, books and journals. Researcher has prepared questionnaire and collect the data from
patients (Taylor, Bogdan and DeVault, 2015).
Data Analysis- It is also one of the most essential part of research methodology. Data
analysis is the process of examining, cleaning, transforming as well as modelling of information
with the purpose of discovering useful data. Without data analysis, research is meaningless, thus
it is very important that data and information should be cleaned before presenting. In this present
research, researcher has used primary method of collecting data by using thematic analysis. With
the help of thematic analysis, scholar can interpret the data by identifying the ways of improving
access to General Practice by reducing their urgent care centre (UCC) attendance. Present study
or research has been based on quantitative data analysis method. Qualitative data analysis
method will more helpful to analyse data into thematic manner.
6

Sampling- This is another most essential part of research methodology. The well-defined
and systematic process of selecting a small group of people by large population. It is not possible
for the researcher to collect the data form large population so in order to overcome this problem,
researcher has selected a small group of people. In this present research, researcher has collected
data from patients who have recently visited an out of hours or emergency department or urgent
care centre (UCC) of National health service organisation (NHS) during normal practice hours
(Lewis, 2015).
Ethical Consideration- Ethical consideration is also an essential part which researcher
have to follow in any manner. This is because if researcher does not consider ethics, norms,
standards than research will be useless. There are numerous ethical consideration which
Researcher in this present research has considered are as follows-
 All patients have involves in the focus group with informed consent.
 All patients are given chances to leave the group if they required.
 Privacy of data has also been maintained (Vaioleti, 2016)
 Patient responses has been managed securely and any data will be kept on-site at the GP
surgery.
Finding
Questionnaire
Name of Organisation:
Name:
Age:
Gender:
1.How long you are using the general practice of NHS?
 2-4 years
 4-6 years
 6-8 years
2.Are you satisfied with the services of National Healthcare Services (NHS) organisation?
 Highly Agree
 Agree
 Highly Disagree
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 Disagree
 Neutral
3. What is the major reason for not attending general practice?
 Difficulty in Booking Appointment
 Inefficient ointment system
 lack of options of General practice
 Lack of information
4.What are the major issues you are facing to access General practice?
 Non availability of doctors in out of hours
 Lack of telephonic booking system
 High Cost
5.What changes you need to improve the services of NHS?
 Improving the appointing system
 Increasing the workforce
 Hiring the new talent
 Balancing the shift or working hours of doctors.
Theme 1: Maximum patients are using the services of NHS since 4-6 years.
Particulars Respondents
2-4 years 4
4-6 years 7
6-8 years 9
8

Theme 2: Patients are not satisfied with the services of National Healthcare Services (NHS)
organisation.
Particulars Respondents
Highly Agree 8
Agree 2
Highly Disagree 6
Disagree 2
Neutral 2
9
2-4 years
4-6 years
6-8 years
0 1 2 3 4 5 6 7 8 9
Respondents

Theme 3: Difficulty in Booking Appointment is the major reason for not attending general
practice.
Particulars Respondents
Difficulty in Booking Appointment 10
Inefficient appointment system 5
lack of options of General practice 3
Lack of information 2
10
Highly Agree
Agree
Highly Disagree
Disagree
Neutral

Theme 4: Non availability of doctors in out of hours is major issues you are facing to access
General practice.
Particulars Respondents
Non availability of doctors in out of hours 13
Lack of telephonic booking system 3
lack of options of General practice 2
High Cost 2
11
Difficulty in Booking Appointment
Inefficient appointment system
lack of options of General practice
Lack of information
0
2
4
6
8
10
Respondents

Theme 5: NHS needs to make the balance in the shift or working hours of doctors.
Particulars Respondents
Improving the appointing system 4
Increasing the workforce 5
Hiring the new talent 3
Balancing the shift or working hours of
doctors.
8
12
Non availability of doctors
in out of hours
Lack of telephonic booking
system
lack of options of General
practice
High Cost

Discussion & Recommendation
Theme 1: Maximum patients are using the services of NHS since 6-8 years.
Interpretation- The above analysis conducted from the patients of NHS states that
maximum patients are using the services of National healthcare services organisation (NHS) said
by 9 patients. They said that they are satisfied with the services offered by NHS care givers and
practitioners. On the other hand, 7 patients are using the services of NHS since 6-8 years. They
said that they face issues when they visit the hospital in late night in the emergency. Apart from
this, 4 respondents are using the services of NHS by 2-4 years.
Theme 2: Patients are not satisfied with the services of National Healthcare Services (NHS)
organisation.
Interpretation- The above analysis conducted from the patients of NHS states that
patients are not satisfied with the services of National Healthcare Services (NHS) organisation as
they said that they face the difficulties in booking appointment which makes the dissatisfied with
the services as 8 are highly satisfied. On the other hand, 2 respondents are supporting that they
are also not satisfied with the services for the same reason. It is also identified that 6 patients are
highly disagreed that the services offered by NHS are good and effective and they are satisfied
13
Improving the appointing system
Increasing the workforce
Hiring the new talent
Balancing the shift or working hours of doctors.
0
2
4
6
8
Respondents

with the services as well as 2 respondents are also not supporting as they said that they are also
satisfied with the services. Furthermore, 2 patients have no answer as they are confused.
Theme 3: Difficulty in Booking Appointment is the major reason for not attending general
practice.
Interpretation- The above analysis conducted from the patients of NHS states that 10
patients said that they are facing issues in booking the appointment of doctors because of work
stress and lack of communication technology. On the other hand, 5 respondents said they also
face trouble in booking appointment and it is because of Inefficient appointment system in NHS.
Addition to this, 3 patients have lack of option in accessing general practices because of less staff
members. Only 2 patients said that lack of information is also a reason for not attending general
practices.
Theme 4: Non availability of doctors in out of hours is major issues you are facing to access
General practice.
Interpretation- The above analysis conducted from the patients of NHS states patients
are facing major issues in accessing general practices because of non-availability of doctors in
out of hours as said by 13 patients. On the other hand, lack of telephonic system of booking is
also one of the major issues that patients are facing as said by 3 respondents. Apart from this, 2
patients have lack of options of general practices in NHS and 2 said that high cost is also another
issue which they are facing to access General practices.
Theme 5: NHS needs to make the balance in the shift or working hours of doctors.
Interpretation The above analysis conducted from the patients of NHS recommend that
NHS should make balance the shift or working hours of doctors as said by 8 respondents. 4
patients said that NHS should increase the workforce. On the other hand, 3 said that NHS should
hire the new talents in the company and 4 said that they should improve the system of
appointment.
RECOMMENDATION
It is recommended that NHS should make some changes which are as follows-
 They should improve the technology like they should use to book appointment of
patients through online webs, telephones and other technologies (Andersen,
Davidson and Baumeister, 2014).
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 They should increase the workforce in NHS so that work stress or load will be
divided.
 They should make balance in the shift or working hours of doctors.
 They should manage the work load of doctors so that they give quality of services
to patients.
 They should make arrangement of staff in out-of hours.
Recommendation strategies
General practices in health care sector which treats all common medical conditions and
refer patients to hospital and other medical services for urgent and specialist treatments at urgent
care centre (UCC). In order to recommended strategies for general practices through which
health care sector can easily maintain proper quality and safety strategies needs. Such as hospital
needs to keep proper patient quality and keep maintained professional staff for working. Second
NHS also helps to keep strengthen management.
Proper regulation and assessment of health professional services can also be adopted by
health care sector. NHS also needs to prepare quality problem solving teams in order to keep the
general practice alive.
ACKNOWLEDGEMENTS
The research cannot be completed without the help of my all colleagues. This work is not
be completed without the financial support of my professor. I am very thankful to him. I am
very thankful to all those whom U have had the pleasure to work during this and other related
projects. I am also very grateful to my tutors for great guidance which is very helpful for me to
complete my study. This research work is very helpful for my future as now I can conduct many
more research.
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REFERENCES
Books and Journals:
Andersen, R.M., Davidson, P.L. and Baumeister, S.E., 2014. Improving access to
care. Changing the US health care system: key issues in health services policy and
management. San Francisco: Jossey-Bass, pp.33-69.
Betancourt, J.R and et.al., 2016. Defining cultural competence: a practical framework for
addressing racial/ethnic disparities in health and health care. Public health reports.
Bibbins-Domingo, K., 2016. Aspirin use for the primary prevention of cardiovascular disease
and colorectal cancer: US Preventive Services Task Force Recommendation
Statement. Annals of internal medicine, 164(12), pp.836-845.
Burwell, S.M., 2015. Setting value-based payment goals—HHS efforts to improve US health
care. N Engl J Med,372(10), pp.897-899.
Coulter and et.al., 2014. Collecting data on patient experience is not enough: they must be used
to improve care. BMJ (Clinical research ed.),348(mar26 1), pp.g2225-g2225.
Gillies, R.J., Kinahan, P.E. and Hricak, H., 2015. Radiomics: images are more than pictures,
they are data. Radiology,278(2), pp.563-577.
Lewis, S., 2015. Qualitative inquiry and research design: Choosing among five
approaches. Health promotion practice,16(4), pp.473-475.
Mackey, A. and Gass, S.M., 2015. Second language research: Methodology and design.
Routledge.
Pecora, P and et.al., 2017. The child welfare challenge: Policy, practice, and research.
Routledge.
Taylor, S.J., Bogdan, R. and DeVault, M., 2015. Introduction to qualitative research methods: A
guidebook and resource. John Wiley & Sons.
Vaioleti, T.M., 2016. Talanoa research methodology: A developing position on Pacific
research. Waikato Journal of Education, 12(1).
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APPENDIX
Questionnaire
Name of Organisation:
Name:
Age:
Gender:
1.How long you are using the general practice of NHS?
 2-4 years
 4-6 years
 6-8 years
2.Are you satisfied with the services of National Healthcare Services (NHS) organisation?
 Highly Agree
 Agree
 Highly Disagree
 Disagree
 Neutral
3. What is the major reason for not attending general practice?
 Difficulty in Booking Appointment
 Inefficient ointment system
 lack of options of General practice
 Lack of information
4.What are the major issues you are facing to access General practice?
 Non availability of doctors in out of hours
 Lack of telephonic booking system
 High Cost
5.What changes you need to improve the services of NHS?
 Improving the appointing system
 Increasing the workforce
 Hiring the new talent
17

 Balancing the shift or working hours of doctors.
18