I-ACT Study I-ACT Study

Improving access to GPs for vulnerable older people

Our research has found that complicated booking systems and poor transport are just some of the many challenges vulnerable older people face in seeing their doctor. One-size-fits-all solutions don’t work for everyone, so our research has created a patient pathway and teamed-up with GP surgeries to develop local solutions, especially to improve the booking system.

Current policies to improve access to GP surgeries, such as weekend opening, sometimes don’t give additional help to those who need heath care the most, leading to misplaced investment. Other research has found that older people, those in rural areas and those who are disadvantaged need health care and are at risk of finding it difficult to see their doctor. Whilst our research focuses on vulnerable older people, many of the findings are applicable to other vulnerable groups.

Patient pathway

First, we developed a pathway showing how people access GP using the example of vulnerable older people in rural areas which has been published here.  This research has been developed into a toolkit for commissioners by NHS England and adapted into a short animation.

Social contract

Second, our in-depth interviews with older people and focus groups with health professionals found evidence of a social contract; where older people are careful not to bother their doctor and in return expect extra goodwill when they need an appointment or home visit. This study is published here.

Finding solutions

Finally, we gave three GP practices £1500, four meetings with the research team and a summary of the previous research and used one practice as a control. Instead of telling practices what to do, we let practices choose. The three GP practices chose changes like receptionists training, signposting of patients to more appropriate services, working with community transport and installing a call queuing system. The study finishes in June, but initial results suggest that those practices that were given support improved the ease of the booking system but found it difficult to improve transport.

Funding:  The research is funded by the National Institute for Health Research

For more information please contact the lead research: Dr John Ford email address john.ford@uea.ac.uk.

Research team

Prof Nick Steel

Prof Andy Jones 

Dr Geoff Wong 

Prof Tom Shakespeare 

Prof Anne-Marie Swart

Dr Erika Sims 

Dr Allan Clark

Prof Garry Barton