Improving Primary Care Access
Challenge
Recent studies have highlighted the pressures facing primary healthcare services, indicating a surge in demand that threatens patient care quality, safety, and the wellbeing of healthcare staff. Surveys among general practitioners have shown a high level of concern about workload pressures affecting care delivery, with many reporting high levels of stress and lower satisfaction compared to international counterparts. It was hypothesised that some of this demand might be self-generated by the practices based on their patient interactions. The adoption of Behavioural Science techniques, successful in various sectors, was proposed as a means to influence both clinician and patient behaviors to
manage demand more effectively.
Solution
The approach was piloted in two large general practices to test its effectiveness in managing patient demand and
optimising resource use. Initial observations included:
The study found that traditional patient interaction methods were reinforcing outdated expectations and demand patterns, missing the benefits of new care models. The pilot focused on three key areas, utilising Behavioural Science
principles:
Patient First Point of Contact:
Implementing nudge techniques to alter patient interaction with the practice, thereby setting new expectations and norms to leverage new
workforce models and reduce missed appointments.
Patient & Clinician Interactions:
Introducing subtle changes in language and messaging, especially during safety netting and consultation conclusions, to prevent
setting inappropriate expectations.
Physical Environment & Signage:
Enhancing practice flow and ensuring consistent messaging through posters, leaflets, and campaigns, both at the first point
of contact and during consultations.
Outcome
After a 6-month trial period, the initiatives proved to be simple, cost-effective, and quick to implement. Staff engagement was key to the successful adoption and iterative refinement of these strategies. The analysis
showed:
The trial demonstrated that applying Behavioural Science principles could effectively manage demand and improve practice efficiency, providing a scalable model for
broader application.
testimonial
The work we have undertaken with the Caja Team has really open our eyes to how important it is to consider behaviour change within design of primary care services to maximize the best use of limited capacity. This work has really engaged the practices involved and the initial observations are being used to co-design innovate new ways of working which will benefit patients and practice staff.
