51 million unable to see a GP by 2015? Why we don't have enough information to say
"In 2015 on more than 51.3m occasions patients in England will be unable to get an appointment to see a GP or nurse when they contact their local practice, according to new research." — Royal College of GPs press release
A predicted rise in the number of times patients will fail to get a GP appointment made the front pages of the Sun and the Times today.
The estimate came from the Royal College of GPs (RCGP). But 51.3 million isn't a reliable estimate of the number of GP appointments that will be missed; as with a similar estimate earlier in the year, it's based on a comparison between two sets of data that aren't comparable.
The number of consultations is set to rise
The RCGP told us it has extrapolated figures on the proportion of patients who are unable to see or speak to someone at their GP using data from the latest GP Patient Survey. The proportion has risen, and according to its analysis if this trend continues it will reach 11.8% in 2015, although the data on which this is based only goes back to June 2012.
The data includes people who spoke to staff who weren't GPs, such as nurses, and people who spoke to staff over the phone rather than in the surgery itself.
The latest official data on the number of consultations at GP surgeries, broken down by age group, is from 2008/09. Researchers from Deloitte have taken the rate of growth in the number of appointments from 1994/95 to 2008/09, as well as information on the numbers of people who will fall into each age band in the future to produce estimates for every year up to 2017/18. It estimated that in 2015/16 there will be 384.3 million consultations. That figure is for all consultations at GP practices, including with nurses.
The RCGP has combined that figure with their 11.8% estimate to come out with a forecast of 51.3 million failed attempts to get an appointment in 2015. But unfortunately we don't have enough information to tell whether or not that's a valid comparison to make - we don't know whether the experience of the patients surveyed on the last time they tried to get an appointment is representative of appointments as a whole.
11.8% of patients is not 11.8% of appointments — an example
Let's imagine two patients.
Anita has a long term health condition and has a regular appointment with her GP ten times a year. She's happy to book these appointments fairly far in advance, and was able to secure ten out of ten required appointments last year.
Barry, on the other hand, only contacted his GP surgery once last year. He was trying to get an emergency appointment but was turned down, meaning he visited A&E instead.
If we survey Anita and Barry, 50% of our sample of two will say they were unable to get an appointment last time they tried. But that doesn't mean 50% of attempts at getting a one were unsuccessful; on 10 out of 11 occasions, patients were able to get an appointment.
It's an extreme example, but the point is that without information on the way respondents to the survey use their GP's services, we can't use their responses to tell us how many attempts to be seen are turned down.