Patients struggling with NHS complexity, says report

For patients and GPs, accessing NHS services can feel like a "maze of dead ends and detours," according to a new survey, which calls for a radical set of reforms to simplify the current system.

The report from the Royal College of GPs and the Patients Association describes a situation in which many patients say they face administrative and procedural barriers that are "confusing, frustrating, and demoralising" and make it difficult for people to get the care they need.

Among the issues highlighted by patients in the study were lengthy waits for appointments, obstacles to changing or cancelling appointments, missing test results, lost referrals, and not being informed of next steps. There are currently more than six million patients on the NHS waiting list for specialist elective appointments.

At the same time, GPs find themselves in a tangled web of administrative burdens, mounting time pressures, and challenges to get patients specialist help when they need it.

"These experiences highlight a shared reality - patients and GPs are often struggling with the same challenges as they try to navigate an increasingly complex system," according to the report, which marks the start of a campaign to try to persuade governments across the UK to make NHS care "simpler to access, better connected, and more sustainable for the future."

The RCGP and PA make several recommendations in the report, at the heart of which is giving patients the ability to understand, navigate, and influence their own care.

Patients and GPs must work together on co-designing care pathways that are easier to navigate, they argue, and every patient should be able to access their information and track referrals via user-friendly systems that are easier to use, better connected, and that reduce administrative burden.

They also say that every patient should be able to see their GP when they need to – whilst acknowledging that this is challenging given the current staffing crisis within the NHS – and call on the government to set out clear plans to train, employ, and retain sufficient GPs to meet the need. Practices should also be resourced so that each patient has a named GP for continuity of care.

One patient cited in the poll said that when you are dealing with multiple specialists across different hospitals, each with their own processes, "it can become very overwhelming very quickly […] and often it's the GP who becomes the guide through that maze."

Patients shared accounts of inconsistent and incompatible digital systems, often failing to provide accessible, reliable information, which points to the challenges faced in the current NHS 10-Year Plan with regard to increased digitalisation of the health service.

"Patients were clear that the priority is not just 'more digital', but systems that are easier to use, reduce uncertainty, and make it clear what happens next," according to the report.

The government has indicated some of the issues highlighted in the report are already being addressed, including a new GP recruitment drive that has resulted in more than 5,000 new doctors working in NHS trusts compared to February 2022, a rapid reduction in waiting lists in around 20 trusts thanks to specialist NHS teams, more funding for primary care, and digital initiatives including an upgraded NHS app and an online hospital for virtual consultations.

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