In this episode, Ben is joined by Catherine Pope, Professor of Medical Sociology at Nuffield Department of Primary Care Health Sciences, to explore how access to general practice really works in practice and what happens to appointment systems over time. Drawing on over 30 years of research and findings from a recent study, the discussion examines the sustainability of different access models, the legacy of initiatives such as Advanced Access, and why practices continually adapt systems to manage demand. The episode explores the limitations of top-down, standardised and digital first solutions, the impact of access systems on patients, reception teams and clinicians, and why variation is often necessary to meet the needs of local populations. The conversation also highlights patient experiences of navigating access, the risks of diversion and looping between services, creative approaches such as the 'Phones and Ladders' game to illustrate access challenges, and the case for more patient-centred, locally adaptable models that prioritise need, continuity and sustainable general practice.

Introduction (00:08)

Your recent study on access to general practice (01:00)

Did you find that practices were able to sustain the benefits of new access systems? (04:04)

Have practices managed to stick with the changes they made over time? (09:41)

Does this impact sustainability, because eventually people stop doing it? (13:39)

'Phones and Ladders' (15:30)

Should access start with local population needs? (19:28)

Are current access outcome measures too crude if they focus only on waiting times? (22:05)

If people want to access the research or learn more, where can they find it? (24:33)

Visit the 'General Practice: Innovation, impact and sustainable change' research here.

For all enquiries about the Ockham podcast, please contact Ben Gowland here.