This discovery was a broad examination of a large and complex problem space. It was intended to identify opportunities for more focused work, which can better understand and seek solutions to the most critical issues identified.

We have identified several issues that appear prevalent in general practice in Wales. The existing digital solutions that could help address them have often not been implemented in a way that meets user needs or integrates well with the rest of a practice’s operation. In some cases, the underlying problems are not well understood.

As a result, these digital interventions are often not working well in their current form and not delivering the anticipated positive outcomes for either citizens or practices.

Surgeries doing their best

Note that this is not a criticism of the individual GP surgeries. It was evident that they were doing their best under challenging circumstances.

We recommend the following opportunities for further work:

  1. Better understanding the nature of demand in GP surgeries. It is likely some proportion of the requests coming into practices could be better served in different ways or avoided altogether. Practices tend to not have the resources to do the data collection and analysis required to achieve this level of insight.
  2. Exploring ways to achieve a greater consistency in how GP services are accessed, across practices. This is important to minimise potential inequities in health outcomes for citizens.
  3. Testing what outcomes can be achieved with a set of multi-channel methods for accessing GP services, which have been designed and tested to work together, around the needs of citizens and practices. This could both improve access for citizens and reduce demand on practices.
  4. Testing what outcomes can be achieved by enabling and promoting online access to citizens’ summary health records. This could lead to a reduction in demand over time, alongside other potential benefits. An evidence-based understanding of both the benefits and disadvantages would allow practices or clusters considering taking this step to make informed decisions.
  5. Exploring how citizens and primary care staff can be more routinely involved in decisions that affect how primary care is delivered. Involving those directly affected by policies or digital tools in the design, selection or testing process makes it more likely that anticipated outcomes are achieved, and unintended consequences mitigated.