Recent findings from the British Social Attitudes survey, analysed in the latest Nuffield Trust report, paint a concerning picture: public satisfaction with GP services in England has fallen to its lowest recorded level. In a year where the NHS faces unprecedented change with the upcoming 10 Year Plan, the steady erosion of trust and satisfaction in what is traditionally seen as the ‘front door’ to the health service should sound alarm bells.
But in the rush to address this dissatisfaction, we must be careful not to prescribe the wrong solution. While expanding access to GP appointments is part of the answer, it is not the whole solution. The deeper issue is one of navigation. Too many patients are trying to get GP appointments by default, when in fact, their needs could be better met by other professionals or services. To truly fix the system, we need to shift focus from simply “getting a GP appointment” to “getting the right care, at the right time, from the right person.”
A symptom of misalignment
The Nuffield Trust report reveals that only 24% of the public are now satisfied with general practice services – a steep decline from the 2010s, when satisfaction regularly hovered above 70%. Much of the dissatisfaction centres around access: long waits for appointments, difficulties contacting surgeries, and perceived rushed consultations. But beneath these frustrations lies a more fundamental problem, primary care is being asked to do too much, and patients don’t always know where to go for help.
General practice has become the default entry point for all health-related concerns, whether they’re clinical, administrative, or social. This leads to an overload of appointments that could have been managed more effectively by a pharmacist, a physiotherapist, or even digital self-help tools. If every road leads to a GP, the system becomes clogged and patients feel let down.
Understanding the ecosystem of care
Primary care should not be equated solely with GPs. It’s an ecosystem that includes practice nurses, mental health practitioners, pharmacists, and community services. Over the past decade, the NHS has invested in expanding this team through initiatives like the Additional Roles Reimbursement Scheme (ARRS). Yet awareness and understanding of these roles among the public remains limited.
Many patients still believe they need to see a GP for everything from a repeat prescription to a sprained ankle because they haven’t been clearly shown otherwise. This is not a failure of patients; it’s a failure of communication and system design, and that’s why at X-on Health we have introduced Surgery Assist, an AI-powered digital assistant designed to transform patient access and navigation within general practice. If we don’t direct people to the right professional from the outset, we end up wasting time, creating bottlenecks, and eroding confidence in the system.
Digital triage and care navigation
True care navigation needs to be embedded within primary care teams. This includes both digital and human support—like trained care navigators who can listen to patients’ concerns and direct them appropriately. A receptionist trained in care navigation is no longer a gatekeeper; they’re a facilitator, helping patients understand their options and access the most effective care.
One of the most promising areas for improvement is digital triage. Used effectively, digital tools such as Surgery Assist can ask a few simple questions and quickly signpost patients to the most appropriate resource, whether that’s an in-person GP appointment, a video consultation, pharmacy advice, or community health support. AI-driven solutions such as this are already improving efficiency and patient outcomes at some practices. Take for example Tudor Lodge in South West London, where optimisation of their telephone systems and the implementation of Surgery Assist has resulted in a 21% reduction in their number of inbound calls and the number of missed calls reducing by two thirds.
Rebuilding trust through clarity
One of the key reasons for declining satisfaction is a sense of opacity – patients don’t understand what’s going on behind the scenes. If they cannot get an appointment they will often call back at 8am the following day, sometimes enduring long phone queues, and then told there are no appointments left.
We can start to rebuild trust by increasing transparency and signposting effectively. Let patients see what services are available. Communicate the roles of different practitioners clearly. Explain what “triage” actually means and how it helps ensure they get timely, effective care. Importantly, show that GP appointments are being preserved for those who genuinely need them while everyone else is still getting the help they need, but through a more appropriate route.
Data and feedback for better primary care
Improving navigation also means measuring how well it’s working. How many patients are being successfully redirected to pharmacy, how many just needed a repeat prescription? What’s the satisfaction rate for those interactions?
Many practices don’t have the tools in place to track patient journeys across different services, or if they do have they may not have been optimised to maximise the benefit. This is a huge missed opportunity. If we want to optimise the system, we need to know what’s working and what isn’t, at a granular level. Only then can we make informed decisions about where to invest and how to redesign access pathways.
Systemic change, not just sticking plasters
Satisfaction with GP services won’t be fixed by hiring more GPs alone, although workforce expansion is still crucial. Nor will it be solved by simply extending hours or offering more appointments. We need to reframe the conversation.
Our job as system leaders, clinicians, policymakers and digital health providers is to ensure patients are getting the support they need in the most efficient, timely and compassionate way possible. That means investing responsibly in systems to support receptionists. It means training staff to use the systems efficiently and it means designing access models that are inclusive, transparent and responsive.
With tools like Surgery Assist, healthcare providers can reduce pressure on overstretched GP services, streamline access to care, and empower patients to take control of their health. By embracing these innovations, the NHS can not only recover but also evolve into a more sustainable, patient-centric system that meets the needs of a modern, diverse population.
We can restore trust in primary care, but only if surgeries implement the right tools efficiently and effectively, signposting patients to the right information, and the right care.
By Sharon Hanley, Director of Primary Care, X-on Health