Are patients getting the choices they need from their GP?
As part of our work on people’s experiences of GP access, we looked at the choices people have when booking GP appointments.
Although most people are positive about their latest contact with their GP practice, our new research shows that choice remains one of the weakest aspects of the GP experience. This confirms the findings from last year’s research, which identified a gap between the choices people wanted and those they received when booking GP appointments.
About our research
Our new research on access to GP services is based on:
- A nationally representative poll of 4,050 adults in England who had contacted their GP in the last 12 months.i
- Findings from four focus groups conducted by Healthwatch. ii
Why did we look at patients’ choices?
Patients do not all need or want the same type of appointment. What works can depend on someone’s health concern, their personal circumstances, and what they need from the consultation.
Our findings suggest that giving people meaningful choices can improve their experience. Yet many patients are still not offered a choice about when, where or how they receive care.
Meaningful choice does not mean that every type of appointment must always be available. It means understanding what a patient needs, explaining the clinically appropriate options and avoiding arrangements that make care difficult or impossible to use.
In our report last year, we found people particularly valued choice over appointment times, whether an appointment was face-to-face or remote, and which health professional they saw. But these choices were not always offered. The gap was generally greater for older people, women, disabled people and people unable to work because of their health.
Key findings
- Choice is one of the weakest parts of people’s GP experience
- Many patients were not offered a choice
- The right appointment depends on the person and their needs
- Patients need options that are clinically appropriate and work for them
- Patients should be helped to understand their choices
- Lack of choice can widen inequalities
Choice is one of the weakest parts of people’s GP experience
Most respondents to our poll, 77%, were satisfied with their latest contact with their GP practice.
But choice received a lower satisfaction rating than every other aspect of the experience we measured.
Only 62% gave a positive rating for how convenient the type, time or format of their support or appointment was.
This compared with:
- 72% for ease of initial contact
- 74% for speed of response
- 78% for clarity of communication
- 75% for the overall helpfulness of the practice.
The poll also found that choice was an important factor in people’s overall satisfaction: people who were offered choices were more likely to be satisfied with their latest contact. Among patients who were given a choice about when their appointment would take place, 92% were satisfied with their overall experience of the contact with their practice.
Satisfaction was also high (87%) among those offered a choice about the appointment location or whether it would be face-to-face or remote.
In comparison, only 76% of people who were offered none of these choices were satisfied.
Many patients were not offered a choice
Among people in our polling who successfully booked an appointment:
- 49% were offered a choice about when it would take place
- 23% were offered a choice between a face-to-face and remote appointment
- 10% were offered a choice about where it would take place
- 32% were offered none of these choices.
The questions are not directly comparable with our 2025 research, which asked how often people received different choices. However, the overall picture is similar: many patients are still not routinely offered choices that could help make an appointment suitable for them.
Experiences were not the same for everyone. For example, 41% of people aged 55 and over were not offered any of the choices we asked about, compared with 21% of people aged 18 to 34.
Similarly, people who were financially struggling were more likely to be offered none of the choices (37%), compared with 29% of those who were to who were financially comfortable (29%).
Women were more likely than men to say they weren’t offered any of these choices, at 35% compared with 29% for men.
These findings reinforce our previous concern that gaps in choice can affect some groups more than others.
The right appointment depends on the person and their needs
People taking part in our focus groups did not have one preferred type of appointment. Their preferences often depended on why they needed care.
Face-to-face appointments were valued when:
- symptoms were new
- a physical examination might be needed
- the issue was complex or difficult to explain
- communication by telephone was difficult
- seeing someone in person would provide reassurance.
“If it’s something simple, a phone call is fine, but if they need to see something, I’d rather go in.” Focus group - people who work full time
Remote appointments worked well for some routine issues, including medication-related queries. They could also be more practical for some people with work or caring responsibilities.
“I don’t mind how I see the GP, I just need an option that works around my job.” Focus group - People who work full time
For some carers, attending in person required considerable planning:
“I get that some people want face to face and there’s value in that, but for me who struggles to even pick up a phone, make an appointment, fit it in around care... The logistics for me to go to an appointment [are] phenomenal.” Focus group - people aged under 60 with long-term conditions
Patients need options that are clinically appropriate and workable for them
Most people who successfully booked an appointment said its timing and type were convenient.
However, people who took part in the focus groups explained why services need to ask what works for each patient.
Participants described telephone appointments being arranged when they believed they needed to be examined in person. Others were unsure whether they could ask for a longer appointment to discuss complex or multiple concerns.
Some people with long-term conditions told us that a standard appointment was not always enough. Some did not know how to request more time, even when their health needs were complex.
Choice also needs to remain available after an appointment is offered. If the timing or format is unsuitable, patients need a straightforward way to discuss an alternative rather than having to accept it or begin the whole process again.
Patients should be helped to understand their choices
Our previous research found that people often had to request particular choices rather than being offered them. The latest focus groups raised similar concerns.
Some participants did not know they could request a longer appointment. Others believed that knowing practice-specific terms, such as asking for the “triage list”, could improve their chances of receiving an assessment.
This risks creating a system where choice works best for people who already understand how it works and feel confident asking for what they need.
Practices should explain relevant options and ask about patient preferences where clinically appropriate. This is particularly important when someone may need more time, a particular appointment format or location, or a reasonable adjustment.
Lack of choice can widen inequalities
Choice is not simply a matter of convenience. For some people, whether an appointment is workable can determine whether they can use it at all.
People in our focus groups described having needs linked to disability, neurodivergence, long-term conditions, language, communication and caring responsibilities.
Carers described finding it easier to arrange help for the person they cared for than to get care for themselves.
“Carers who have no respite, who have no downtime, who struggle to pick up that phone... how many carers aren’t looking after their health?” Focus group: people with long-term conditions aged under 60)
Participants also described how managing repeated steps to try to book an appointment could be especially difficult for people with ADHD. People with additional communication needs could find that an appointment format that worked for another patient did not work for them.
These experiences reflect what we found in 2025: the choice gap does not affect everyone equally.
If services rely on patients to identify and repeatedly request suitable arrangements, people who face the greatest barriers may be least able to exercise choice.
In the focus group of people with long term conditions, one participant said they had been able to book double appointments to have the time they needed with the GP, but didn’t know when it was appropriate to ask for one.
Other focus group participants didn’t know it was possible to ask for double appointments at all:
Focus group participant 1: no one has ever said to me that I need a double appointment or tell me to stop speaking so maybe they just know my anxiety and history and just allow it but…
Researcher: Do the people outside (area) is that the experience you get from (surgery name)?
Participant 2: Um I wasn’t aware you could book double appointments
Participant 3: I didn’t either I must admit although …, I have had a double appointment I just wasn’t aware I could ask for one”
Patients should not have to know the right words or repeatedly press for consideration of their needs. Choice should be built into how GP care is offered.
How can the NHS provide meaningful appointment choice?
Improving GP access is not only about how quickly an appointment is provided. It must also consider whether the care offered is appropriate and usable for the patient.
We are calling for the following actions to improve patients’ experience of choice at GP practices:
Make meaningful choice a measure of progress
NHS England and the Department of Health and Social Care should make meaningful patient choice a core measure of progress on GP access.
This should include using Patient Reported Experience Measures (PREMs) to establish whether people are offered appropriate choices about appointment timing, format, location and healthcare professional, and whether their preferences are met where clinically appropriate.
Proactively offer relevant choices
GP practices should not rely on patients knowing what to request. Staff and booking systems should explain relevant appointment options and ask about preferences where clinically appropriate.
Make adjustments easier to request
GP practices should identify, record, and act on people’s communication and accessibility needs. They should clearly explain how patients can request choices that relate to reasonable adjustments, language support or a longer appointment.
*Savanta interviewed 4,050 adults in England online between 7 and 23 July 2026 who have tried to contact their GP in the last 12 months. Quotas were applied and data is weighted by age, region, gender and ethnicity to ensure a representative sample.
**We commissioned four Healthwatch to run focus groups for us:
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People on a low income/living in a deprived area -Healthwatch Brighton and Hove
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People who work full time – Healthwatch Leeds
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People aged under 60 with at least one long term condition – Healthwatch Northumberland
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People aged 70 or over – Healthwatch Suffolk
