22/03/2013 10:03 GMT | Updated 22/05/2013 06:12 BST

Primary Care, Access Denied

Every 16 minutes The Patients Association Helpline offers advice and information to a patient, relative or carer. Increasingly concerns relate to community, rather than hospital based care. In fact as many as nine out of 10 interactions with the health and social care system are through primary care services, such as visits to the GP.

Our new report 'Access Denied' is focussed on how we create a system in every community that is safe, easy to understand and convenient to access.

Our research shows that the public often face a complex and convoluted system at a time when they need urgent care. Nearly 80% or respondents to our survey said they didn't feel safe relying on NHS out-of-hours care. Almost half of those who had used an out-of-hours provider in the past two years said they were not satisfied with the service they had received.

During the daytime poor access was also of real concern. More than a third of respondents (38%) have had to take a day off work to attend an appointment with a GP, for instance. With too many unable to get through to their surgery on the phone or book an appointment in the evening or over the weekend.

The Patients Association is calling for key changes in the way primary care services are delivered, so they are focussed around the public.

Firstly, the NHS Commissioning Board should review emergency provision across the primary, as well as acute sector. In order to provide good quality and cost effective care we must tackle the notion of A&E Departments as 'one stop shops'. Patients want better care, closer to home. This care must be safe and clinically led.

Secondly, the public deserve expanded choice and access to primary care services. No longer should patients be restricted by geographical limitations but treated on the basis of their needs. The government should look to abolish GP boundaries so patients can attend a surgery near work or by their child's school for example.

Thirdly, Clinical Commissioning Groups must make one of their top priorities improved awareness campaigns for the public in every local community. When faced with medical emergencies patients need to know where to go and how to get support through high quality, easy to understand signposting. At the moment an array of services, including urgent care clinics, walk-in centres, NHS 111 and NHS Direct, paint a confusing picture.

We need an NHS in every community that operates effectively, safely and compassionately during and outside of office hours. Keeping people out of hospital and living independent, healthier lifestyles means delivering more integrated and accessible community-based care.

Achieving a reformed health and social care system that goes beyond nine-five, and is based as close to where people live and work as possible, is the call of our report. The Patients Association looks forward to campaigning alongside the public, health professionals and policy makers to deliver radical change in the way care is accessed locally across the UK.

The Patients Association motto is 'listening to patients, speaking up for change.' The charity's Helpline can be contacted by phone on 0845 608 4455 or by email through