Primary Care

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Access to GP Practices

This project built on the findings and recommendations of 'Minding the gaps' and aimed to provide a better understanding of the barriers that BME communities face when accessing GP practices. The 18-month research project involved interviewing 55 patients and 16 health professionals in KCW.

The purpose of the Access to GP Practices project was to improve access to GP services through addressing three key issues: registering and appointment-making; the quality and availability of the interpreting services; and the interaction between BME patients and GPs and other practice staff.

To achieve this, the Forum involved all key stakeholders in the development of the project from the outset. The research has sought the views of GPs, practice managers, Chairs of the Clinical/Professional Executive Committees, Chairs of the PBC Clusters as well as BME patients. The aim was to ensure that the views of all those involved were represented. Therefore, the findings and recommendations of this report reflect what the various stakeholders perceive to be the best way forward.

Overall Recommendations

The recommendations of this report have been underpinned by the following principles:

• As commissioners, the PCTs should ensure that commissioned primary care services are flexible and responsive to the needs of all groups. They should also commission community groups and the BME Health Forum to carry out their responsibilities in implementing the recommendations set out in this report.
• The GP practices should be more responsive to the needs of their diverse patients. Providing a flexible and responsive service will improve equity in healthcare.
• BME community groups should seek funding to develop community-based projects for improving access to primary care services for their communities.
• Alongside their lobbying for getting the BME issues on the agenda, the BME Health Forum and community groups should use their knowledge of BME communities to propose solutions to overcome the barriers to access.

Specific key recommendations

a) Registration

• The PCTs should provide guidance for practices on entitlements, requirements and documentation.
• Practices should ensure fair and transparent processes in registrations by putting in place procedures which are based on this guidance.
• The PCTs should work with the BME Health Forum to produce factsheets for communities (including PALS as a route to raise concerns).
• The PCTs to introduce a system requiring the reporting and referring of anyone who has been refused registration to PALS.

b) Interpreting

• Practices should seek the feedback of their patients on interpreting services.
• The BME Health Forum should work with practices to identify and develop good practice in relation to providing interpreting support.
• The PCTs should produce/reissue guidance and arrange training for Practice staff on working with interpreters.
Practice should consider fluency in a community language as a desirable criterion when recruiting practice staff.

• The PCTs should have the provision of interpreting services as a key requirement in all future commissioned services.
• The BME Health Forum and the community groups should encourage patients to report dissatisfaction with service, either through a system in the community sector or through PALS.
• The issue of patients bringing their children to interpret needs to be addressed as a matter of urgency. Practices must refuse to treat patients who bring their children to interpret for them, except in emergencies.
• The PCTs should lead a full joint review, in partnership with all other stakeholders, to revise/establish standards for interpreting support across KCW.

c) Relationships

• The PCTs should review/develop training programmes for practice staff to ensure that Knowledge & Skills Framework (KSF) competencies for Equality & Diversity are effectively integrated.
• Practices should monitor their patient lists and take steps to ensure that their patient groups/panels reflect the diversity of their patient population.
• Practices should use patient groups/panels, local community groups and the BME Health Forum as a route for improving their understanding of local communities and communities' understanding of NHS services and practices.
• The PCTs should require practices to undertake patient profiling.
• The BME Health Forum should work with practices to identify and develop good practice.
• The PCTs, the BME Health Forum and the PBC Clusters should jointly produce fact-sheets for community groups on NHS Primary Care and how it works.
• Community groups and the BME Health Forum should actively disseminate and distribute these fact-sheets.