ArticleBMJ open2023
How is primary care access changing? A retrospective, repeated cross-sectional study of patient-initiated demand at general practices in England using a modern access model, 2019-2022.
Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 13 citations in OpenAlex.
- Practice-level support delivers return on investment for general practice.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- Missingness is a subset of discontinuity.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- Geospatial Visualisation of Distance to General Practitioner Facilities with Population Density Patterns in the United Kingdom.Epidemiologia (Basel, Switzerland) · 2026Article
- "Loops and hurdles": secondary analysis of patient interview data to explore the experience of patient access to UK general practice.BMC primary care · 2026Article
- Remote Access to Primary Care: Theorising 'Care Navigation'.Sociology of health & illness · 2026Article
- Choreographing Triage: Making Patient Requests 'Flow' Through Digitally Enabled Systems of Access and Decision-Making in NHS Primary Care.Sociology of health & illness · 2026Article
- Hybrid Care Modifications in the Delivery of Nonpandemic Care During the COVID-19 Pandemic: Scoping Review.Journal of medical Internet research · 2026Article
- English general practice in a period of change: a mixed-methods study of staff and patient perspectives.BJGP open · 2026Article
- Healthcare inequalities in general practice due to educational level: A retrospective cohort study analysing patients' presentation and GP response to requests.The European journal of general practice · 2026Article
- Article
- Preference for Face-to-Face Contraceptive Service Delivery Post-COVID-19 Pandemic: A Cross-Sectional Study.BJOG : an international journal of obstetrics and gynaecology · 2025Article
- Article
- Patients' Use of e-Consultations as an Alternative to Other General Practitioner Services: Cross-Sectional Survey Study.Journal of medical Internet research · 2025Article
- Primary care stability as a social determinant.Frontiers in health services · 2025Article
- Challenges to quality in contemporary, hybrid general practice a multi-site longitudinal case study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- The Use of Online Consultation Systems and Patient Experience of Primary Care: Cross-Sectional Analysis Using the General Practice Patient Survey.Journal of medical Internet research · 2024Article
- Patients' suggestions for improvements to text-based e-consultations. An online survey of users of the national health portal in Norway.Frontiers in digital health · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo explore trends in patient-initiated requests for general practice services and the association between patient characteristics including demographics, preferences for care and clinical needs and modes of patient contact (online vs telephone), and care delivery (face-to-face vs remote) at practices using a modern access model.
designRetrospective repeated cross-sectional study spanning March 2019 to February 2022.
settingGeneral practices in England using the askmyGP online consultation system to implement a modern general practice access model using digital and non-digital (multimodal) access pathways and digitally supported triage to manage patient-initiated requests.
participants10 435 465 patient-initiated requests from 1 488 865 patients at 154 practices.
resultsMost requests were initiated online (72.1% in 2021/2022) rather than by telephone. Online users were likely to be female, younger than 45 years, asking about existing medical problems, had used the system before and frequent attenders (familiar patients). During the pandemic, request rates for face-to-face consultations fell while those for telephone consultations and online messages increased, with telephone consultations being most popular (53.8% in 2021/2022). Video was seldom requested. More than 60% of requests were consistently delivered in the mode requested. Face-to-face consultations were more likely to be used for the youngest and oldest patients, new medical problems, non-frequent attenders (unfamiliar patients) and those who requested a face-to-face consultation. Over the course of the study, request rates for patients aged over 44 years increased, for example, by 15.4% (p<0.01) for patients aged over 74 years. Rates for younger patients decreased by 32.6% (p<0.001) in 2020/2021, compared with 2019/2020, before recovering to prepandemic levels in 2021/2022.
conclusionsDemand patterns shed light on the characteristics of patients making requests for general practice services and the composition of the care backlog with implications for policy and practice. A modern general practice access model can be used effectively to manage patient-initiated demand.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.