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Disabled people struggling to access GP appointments

13/03/15
  • Access to primary care services including GPs, dentists and opticians is the public’s number one health concern, according to the local Healthwatch network*
  • A study of 550 GP practices and feedback collected from 11,000 patients reveals that, despite overall satisfaction with primary care being high, there are significant issues for some – particularly for those who are deaf, blind or use a wheelchair
  • Local Healthwatch reports reveal stories of relatives carrying family members up stairs and a 5-year-old girl translating between a GP and her deaf mother

According to the latest GP Satisfaction Survey, 85 per cent of people say they are satisfied with their family doctor and 84 per cent say the same about their local dentist services.

Yet studies conducted by 55 local Healthwatch from all around the country suggest that there are significant issues of concern for some groups of people, particularly for those with hearing, visual and mobility impairments.

We have compiled the findings into a single report which uses patients’ real life experiences to highlight areas where people want to see improvement.

These include:

Physically accessing GP and dentist surgeries

In Luton 26 out of 39 GP surgeries did not have easy access for wheelchair users and 61% of patients at one surgery were unhappy with access, with one relative explaining how they had to “literally carry Mum up the stairs”. In Redcar and Cleveland 14 out of 16 dental practices were found to not be fully accessible, whilst a purpose built surgery designed to meet all access needs has never been occupied.

Problems making an appointment

Others found it hard to arrange an appointment in the first place. One patient from East Sussex told us how making an appointment was the hardest part for as her GP surgery would not bend their policy of on-the-day only appointments, meaning she could not find a suitable carer to take her to her appointments in time. Elsewhere in the country deaf patients are also being told they can only book over the phone.

Problems with communication

In Northamptonshire only one out of five GP surgeries visited by local Healthwatch used basic sign language and in Kirklees we heard of one incident where a deaf patient’s five-year-old daughter had to translate for her due to shortage of BSL translation services. In Oxfordshire concerns were raised by visually-impaired patients who could not read important information about their medication, but were not granted extra-long appointments with their GP to go through the instructions and potential side effects.

By law, under the Equality Act 2010, all health and social care providers are required to make ‘reasonable adjustments’ to make sure that a disabled person can access and use the service as close as possible to the way a non-disabled person would.

This means that all GP and dental surgeries should aim to provide suitable access for patients with hearing, visual and mobility impairments, including those in wheelchairs, as well as older people and those with learning disabilities. In addition, they should provide suitable means of communication, so that it is easy for people to book appointments in the first place.

Local Healthwatch are now using this evidence and working with local commissioners to address these issues on the ground and improve the experience of patients whose views are not always heard.

At a national level, we will be raising these concerns with the Department of Health and NHS policy makers and calling on them to review how improvements can be across the country to ensure everyone has equal access to vital frontline NHS services.

Our Chair, Anna Bradley, said:

“We know from our conversations with the public that many are satisfied with the overall service they receive – yet, when we dig beneath the surface, their experiences tell a different story, including reports from many patients with disabilities about communication problems and physical access barriers making it difficult for them to attend important appointments.

“Where ever physically possible, we want to see every GP and dentist surgery equipped with appropriate disabled access and provide hearing loops and translation service for those who are hearing impaired. We also want services to make it seamless and simple for disabled patients to communicate with them about booking appointments, arranging follow-up treatment and taking their medication.

“These are basic requirements that all GP and dental practices are required to deliver, so a good quality service is available for all.”

Prof Steve Field, Chief Inspector of General Practice at the Care Quality Commission said:

“Although primary care services are under increasing pressure across the country, it is great that 85% of people have reported in the GP Satisfaction Survey that they remain satisfied with their family doctor and 84% have said the same about their local dentist.

“This is reflected in our inspections of general practices, with well over 80% of services having achieved a Good or Outstanding rating to date. There is a lot of high quality practice out there and so it is important to celebrate this when we find it and for others to learn from what they are doing well.

“However, the findings from Healthwatch on the need to improve access for people with disabilities are worrying. We all have a responsibility to look after the most vulnerable in our society and that includes those with mobility, hearing and visual difficulties. I urge dental and GP surgeries to review the systems and support they have in place for them. We look at accessibility as part of our comprehensive inspection programme and so this work will help our teams focus their investigations even more.**

Notes to editors

* A survey of all 152 local Healthwatch conducted in November and December 2014 showed that primary care is the public’s number one health concern in 2015, based on the evidence they have collected from their local communities over the last year. In total, 63 local Healthwatch flagged primary care services as their focus, citing reports from the public about poor appointment booking systems, short appointment slots and poor staff attitude, particularly from receptionists.

**CQC has rated 346 primary medical services across England to date, using its new inspection model. Of these 11 are Outstanding, 292 are Good, 34 are Requires Improvement and 9 are Inadequate. For further information visit the CQC website

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