Access systems in general practice: a systematic scoping review
<p><strong>Background:</strong> 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.</p> <p><strong&g...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
Royal College of General Practitioners
2024
|
| _version_ | 1826315184516366336 |
|---|---|
| author | Eccles, A Bryce, C Driessen, A Pope, C MacLellan, J Gronlund, TAC Nicholson, BD Ziebland, S Atherton, H |
| author_facet | Eccles, A Bryce, C Driessen, A Pope, C MacLellan, J Gronlund, TAC Nicholson, BD Ziebland, S Atherton, H |
| author_sort | Eccles, A |
| collection | OXFORD |
| description | <p><strong>Background:</strong> 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.</p>
<p><strong>Aim:</strong> To systematically consolidate the current international evidence base related to different types of GP access systems.</p>
<p><strong>Design and setting:</strong> Scoping review examining international literature.</p>
<p><strong>Method:</strong> 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.</p>
<p><strong>Results:</strong> In total, 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 that 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 have become more popular in recent years.</p>
<p><strong>Conclusion:</strong> This synthesis provides a useful tool in understanding access systems’ aims, design, and implementation. With focus on alleviating demand, patient-focused outcomes appear to be underinvestigated and potentially overlooked during design and implementation. More recently, digital services have been promoted as offering patient choice and convenience. But a context where demand outweighs resources challenges the premise that extending choice is possible.</p> |
| first_indexed | 2024-09-25T04:04:24Z |
| format | Journal article |
| id | oxford-uuid:f0fa0bfa-5fae-4442-8615-47f2ee3bafcc |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-12-09T03:20:55Z |
| publishDate | 2024 |
| publisher | Royal College of General Practitioners |
| record_format | dspace |
| spelling | oxford-uuid:f0fa0bfa-5fae-4442-8615-47f2ee3bafcc2024-11-08T09:39:43ZAccess systems in general practice: a systematic scoping reviewJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f0fa0bfa-5fae-4442-8615-47f2ee3bafccEnglishSymplectic ElementsRoyal College of General Practitioners2024Eccles, ABryce, CDriessen, APope, CMacLellan, JGronlund, TACNicholson, BDZiebland, SAtherton, H<p><strong>Background:</strong> 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.</p> <p><strong>Aim:</strong> To systematically consolidate the current international evidence base related to different types of GP access systems.</p> <p><strong>Design and setting:</strong> Scoping review examining international literature.</p> <p><strong>Method:</strong> 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.</p> <p><strong>Results:</strong> In total, 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 that 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 have become more popular in recent years.</p> <p><strong>Conclusion:</strong> This synthesis provides a useful tool in understanding access systems’ aims, design, and implementation. With focus on alleviating demand, patient-focused outcomes appear to be underinvestigated and potentially overlooked during design and implementation. More recently, digital services have been promoted as offering patient choice and convenience. But a context where demand outweighs resources challenges the premise that extending choice is possible.</p> |
| spellingShingle | Eccles, A Bryce, C Driessen, A Pope, C MacLellan, J Gronlund, TAC Nicholson, BD Ziebland, S Atherton, H Access systems in general practice: a systematic scoping review |
| title | Access systems in general practice: a systematic scoping review |
| title_full | Access systems in general practice: a systematic scoping review |
| title_fullStr | Access systems in general practice: a systematic scoping review |
| title_full_unstemmed | Access systems in general practice: a systematic scoping review |
| title_short | Access systems in general practice: a systematic scoping review |
| title_sort | access systems in general practice a systematic scoping review |
| work_keys_str_mv | AT ecclesa accesssystemsingeneralpracticeasystematicscopingreview AT brycec accesssystemsingeneralpracticeasystematicscopingreview AT driessena accesssystemsingeneralpracticeasystematicscopingreview AT popec accesssystemsingeneralpracticeasystematicscopingreview AT maclellanj accesssystemsingeneralpracticeasystematicscopingreview AT gronlundtac accesssystemsingeneralpracticeasystematicscopingreview AT nicholsonbd accesssystemsingeneralpracticeasystematicscopingreview AT zieblands accesssystemsingeneralpracticeasystematicscopingreview AT athertonh accesssystemsingeneralpracticeasystematicscopingreview |