Use of services
Home visits fall to 4% of GP consultations
NHS GP consultations: percentage distribution by site of consultation, GB
Over the past 30 years GP home visits have declined as a proportion of all consultations, reflecting the increase in the proportions of both telephone and surgery consultations. In 2003, 86 per cent of GP consultations in Great Britain took place in surgeries or health centres compared with 73 per cent in 1971. Over the same period telephone consultations more than doubled from 4 per cent in 1971 to around 10 per cent between 1998 to 2003. In contrast, the proportion of home visits declined by a fifth from 22 per cent in 1971 to 4 per cent in 2003.
Recent surveys of NHS patients' experience of GP services in England show satisfaction with GP services generally remains high. However, more patients reported having to wait for appointments: 72 per cent said they had to wait two or more days to see their preferred GP compared with 63 per cent in 1998. In 2002 patients contacting the out of hours service were less likely to receive a home visit (33 per cent) than in 1998 (47 per cent). Those receiving home visits out of surgery hours were also more likely to wait an hour or more for a doctor to arrive in 2002 than in 1998 (55 per cent compared with 47 per cent).
Number of calls handled by NHS Direct, 1998/99 - 2003/04, England
Since 1972 the average number of GP consultations per person in Great Britain has remained relatively stable at around four consultations per year. However, over the years the role of the practice nurse in GP surgeries has expanded significantly, particularly in the management of chronic diseases (eg diabetes, asthma) and preventive services (eg vaccinations and contraceptive advice). In 2003, 5 per cent of people in the UK reported consulting a practice nurse in the past fortnight compared with 15 per cent consulting their GP.
There are now also new ways to access primary care health services, serving mainly as an additional out of hours service. These include NHS Walk-in centres (usually sited in hospitals and city centres) and NHS Direct.
NHS Direct was launched in England in March 1998 to complement GP services. It is a 24-hour nurse-led telephone helpline, which provides quick and convenient access to health care information and advice. NHS Direct has been gaining in popularity with the general public. The number of calls handled has been increasing year on year, from around 100,000 calls in 1998/99 when it was launched to 6.4 million in 2003/04. Similar services have been set up in Wales and Scotland.
Sources: General Household Survey, Office for National Statistics NHS Direct
Note: GHS update. Data prior to 1998 are weighted. NHS GP consultations in the 14 days before interview. Surgery includes consultations with a GP at a health centre and those who had answered 'elsewhere'.
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