Sinnott Carol, Price Evleen, Ansari Akbar, Fisher Rebecca, Beech Jake, Alderwick Hugh, Dixon-Woods Mary
The Healthcare Improvement Studies Institute, University of Cambridge, Cambridge, UK
The Healthcare Improvement Studies Institute, University of Cambridge, Cambridge, UK.
BJGP Open. 2025 Jul 23;9(2). doi: 10.3399/BJGPO.2024.0184. Print 2025.
Although increasing numbers of appointments are being provided, public satisfaction with access to UK general practice is declining. Previous attempts to improve access have not been systematically collated.
To identify interventions to improve access to general practice in the UK, to organise these interventions into thematic categories, and to identify which aspects of access are targeted.
DESIGN & SETTING: Narrative systematic review.
A three-stage search was conducted to identify interventions used to improve access to NHS general practice. Using an iterative process, we generated thematic categories to classify interventions according to how they are intended to work. We assessed which aspects of access they addressed using the seven-feature Candidacy Framework.
The search identified 449 relevant sources reporting on interventions to improve access to general practice over the period 1984-2023. We generated six overarching thematic categories into which we organised these interventions: appointment innovations; direct patient access to services; increasing the number and range of professionals available in general practice; offering contacts beyond core hours, core settings, and core services; supporting patient engagement; and supporting the wider structures of general practice. We assessed which features of candidacy were addressed, with 'permeability' (the ease with which people can use services) emerging as the most frequent feature.
Multiple and diverse attempts have been made to improve access in general practice over a 40-year period. This curated, thematised catalogue offers an important resource for future efforts to improve access.
尽管提供的预约数量在增加，但英国公众对获得全科医疗服务的满意度却在下降。此前改善就医便利性的尝试尚未得到系统整理。
确定改善英国全科医疗服务就医便利性的干预措施，将这些干预措施按主题分类，并确定针对就医便利性的哪些方面。
叙述性系统综述。
进行了三个阶段的检索，以确定用于改善国民保健服务（NHS）全科医疗服务就医便利性的干预措施。通过迭代过程，我们生成了主题类别，以便根据干预措施的预期作用方式对其进行分类。我们使用七要素候选框架评估它们所针对的就医便利性的哪些方面。
检索确定了449个相关来源，报告了1984年至2023年期间改善全科医疗服务就医便利性的干预措施。我们生成了六个总体主题类别，并将这些干预措施归入其中：预约创新；患者直接获得服务；增加全科医疗服务中可用专业人员的数量和范围；在非核心时间、非核心场所和非核心服务之外提供联系方式；支持患者参与；以及支持全科医疗服务的更广泛结构。我们评估了所涉及的候选特征，其中“可及性”（人们使用服务的难易程度）是最常出现的特征。
在40年的时间里，人们为改善全科医疗服务的就医便利性进行了多种不同的尝试。这个经过整理、主题化的目录为未来改善就医便利性的努力提供了重要资源。
