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We are evaluating patients' experience of care received in the GP Extended Access Hubs in Sheffield
In the UK, urgent medical care is available through a range of services, including GP practices, pharmacies, walk-in centres, out-of-hours care, and hospital emergency departments (EDs). While GPs and community care can address most health concerns, more people are turning to EDs for conditions that GPs could manage. This is partly because GP appointments can be hard to get, and people’s expectations of care are changing. As a result, EDs are becoming overcrowded, straining the system and increasing waiting times.
To address this, the NHS has introduced “extended access hubs”—centres offering same-day appointments during evenings and weekends. Staffed by teams of healthcare professionals, such as GPs, nurses, paramedics, and physician associates, these hubs aim to make urgent care more accessible. However, it is still unclear whether they meet patients’ needs, especially for those with more complex or ongoing health conditions, who might benefit more from seeing their usual healthcare providers.
Challenges of Extended Hours Hubs
While these hubs have the potential to improve access, they can also introduce new challenges:
1) Mismatch of Care: Hubs are designed for straightforward health issues, but patients with complex or long-term conditions often require continuity of care from familiar providers. This continuity builds trust, enhances safety, and reduces hospital admissions for these patients.
2) Barriers to Access: Some patients may face difficulties reaching hubs due to location, unfamiliarity with the service, or challenges navigating a new healthcare system. These issues are especially problematic for disadvantaged groups who often face the greatest barriers to care.
3) Awareness and Understanding: Many patients may not know about urgent care hubs or may be unsure how they differ from other services. This confusion could lead to underuse or inappropriate visits to the hubs.
4) Geographical and Social Inequities: Rural or underserved areas may have fewer hubs, leaving some patients with limited options. Language barriers, digital exclusion, and financial challenges can further limit access for vulnerable groups.
5) Patient Expectations: Patients accustomed to traditional GP services may find the hub model unfamiliar or confusing. If their care expectations are not met, they could feel dissatisfied or need to visit another provider.
Our Aims
This research aims to understand patients’ experiences with GP extended access hubs, including how use of hubs impacts on patient’s future health care use and choices and how this aligns with NHS policy on extended access hubs.
Methods
This is a multi-method, sequential, qualitative co-designed study that is being undertaken at 2-sites.
Observation of Clinical Consultations
Researchers will observe 50-75 clinical consultations (with patient consent) with a focus on understanding patients’ experience of the consultation at the hub as well as patient-clinician interactions, communication, and decision-making.
We aim to ensure representation of patients with diverse characteristics—including ethnicity, socioeconomic status, geographic location, and age—who attend appointments at varying times and days, including evenings and weekends
Patient Interviews
We will also conduct 25-30 interviews with patients after their hub visit to explore patients’ experiences of the care received at the hub.
Why this research matter
This research will provide valuable insights into how patients use and experience GP Extended Access hubs. We are working with our Project Partner,
Primary Care Sheffield to identify areas where care processes could be improved to enhance patient satisfaction and streamline service delivery.
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