Patients call for same-day appointments; online access to information

A recent survey about the impact of COVID-19 on people’s access to health care found nearly all patients wanted same-day appointments for urgent issues.

The survey of approximately 25,000 people was carried out in June 2020 by the Health Quality & Safety Commission (the Commission), with primary health organisations (PHOs). Its goal was to understand people’s experience of accessing health care during and after the COVID-19 lockdown.

‘We wanted to find out, for example, who delayed or deferred care during lockdown, why and what they did instead?’ says Dr Marcia Walker, member of the Patient Experience of Care Governance Group.

Nearly all respondents said they would like same-day appointments to be available for urgent issues. This echoes findings from a  review of the 2019 primary care survey which found that 37 percent of people reported they were able to see their usual GP on the same or next day.

‘The demand for urgent appointments on the same day are important findings for policy makers to be aware of for the implementation of the health and disability system review,’ says Dr Walker.

‘Capacity is an issue across many general practices due to current funding arrangements. General practice is anticipating further investment in primary health care resourcing and funding to enable general practice teams to offer same day appointments.'

Patients also wanted prescriptions to be sent to their pharmacy for pick up, and for test results to be made available on an online portal.

‘Patients had to access health care in a completely different way during lockdown,’ says Dr Walker.

‘During the level 3 COVID-19 lockdown, 47 percent of general practice appointments were by phone, and 4 percent by video conference.

‘Respondents found remote appointments saved time due to less wait time, less time off work and no travel time. They also found having an appointment at home more relaxed, they didn’t have to find childcare, and didn’t need to be around others who were unwell.

‘The preference for telehealth consulting is shared by practitioners and patients alike. Telehealth reduces the risk of spreading all types of infections’, Dr Walker says.

‘However, it doesn’t suit all patients and we are seeing this in the return to pre-COVID levels of in-person appointments.’

The Commission regularly runs patient experience surveys. In this survey, a higher than usual percentage of people responded positively to patient experience questions. These included questions on being listened to, being informed, having things explained and being treated with respect.

‘These positive findings recognise the exceptional work of general practice during the first COVID-19 lockdown and we’d like to celebrate that.’

Other findings were:

• During the level 3 COVID-19 lockdown, most people had an in-person (49 percent) or phone (47 percent) appointment, with 4 percent held via videoconference. Since leaving lockdown, appointments are returning to pre-COVID modes, with around 90 percent being in person
• Reasons people were not able to access care during lockdown were:
  • alert level restrictions meant they were unable have a face-to-face appointment
  • people did not perceive the health issue as being urgent enough
  • concern around making health providers too busy
  • concern about catching COVID-19
• Māori and Pacific peoples were significantly less likely to report having a phone or video appointment compared with non-Māori, non-Pacific when they were not able to access health care as they normally would
• Respondents said they liked remote appointments because they:
  • were not around others who were unwell
  • saved time due to faster appointments, less wait time, less time off work and no travel time
  • found having an appointment at home more relaxed and they didn’t have to find childcare
• Thirty-six percent of respondents didn’t dislike anything about virtual appointments. For those who did experience difficulties with virtual appointments, this was due to:
  • difficulties showing physical symptoms
  • it being harder to explain issues
  • it being hard to hear/understand
  • privacy
  • technical issues (phone, video or internet).

See A survey of patient experience in New Zealand during the first COVID-19 lockdown for further information.