Knowledge has to be improved, challenged, and increased constantly, or it vanishes. Peter Drucker




Are there practices or circumstances in which evidence shows that methods such as Patient Access should not be used?
A significant finding from the research was that practices employing the method were highly diverse, from the lowest to the highest deciles of deprivation, from inner city, suburban and rural settings, young and old demographics, single hander to very large practices, and all parts of the UK.


There is no evidence of a practice situation which is unsuitable.



From over 200 GPs using the method in practice, we are aware of 2 cases where a doctor has left a practice as they felt unable or unwilling to take on the change.  We know of one other case where a doctor remained but doing no telephone consulting.  It seems that perhaps around 1% of doctors find they cannot adapt, but in any given practice it is most likely that all doctors will be satisfied.  Aptitudes vary, especially at first, but most find they quickly adapt


We provide training in telephone consulting skills for clinicians, delivered by GPs who do it all the time.


Side effects


We know that patient contacts are likely to increase, perhaps by 50%.  This is because patients who previously gave up without an appointment, often very frustrated, will now be contacted by a doctor.  But greater efficiency means that the increased numbers can be dealt with in less time, as the evidence shows.



It is likely that a small minority of patients may not like the change, and may complain.  As far as possible the practice should respond to any complaints.  A small number of these may require special access, eg for those with no phone or very deaf, others can be responded to with explanations.  A chart showing how much quicker it is to see the doctor can be useful evidence.  The majority experience significant benefits:  evidence of this can help to convince skeptical patients.