Abstract

Background
The rise in telephone consultations post-pandemic has transformed primary care delivery in the UK and globally. While offering improved access and efficiency, concerns persist around its impact on patient satisfaction, especially for vulnerable populations. Qualitative studies cite issues such as reduced rapport, missed safeguarding cues, and difficulties in data gathering, yet population-level quantitative evidence remains limited.

Aim
To assess whether increased telephone consultation use in English general practices is associated with changes in patient-reported overall experience.

Methods
A cross-sectional multivariate analysis was conducted using national datasets. Six months of data (Oct 2022–Mar 2023) from NHS England’s Appointments in General Practice dataset were joined with recent GP Patient Survey data on overall experience (Jan–Mar 2024). Multivariate linear regression adjusted for confounders including practice-level deprivation, list size, rurality, dispensing status, and patient sociodemographic factors (ethnicity, age, sex, employment).

Results
Higher telephone consultation use was significantly associated with lower overall patient experience (β = -0.05, p < 0.001), independent of socioeconomic and demographic factors. Practices in more deprived, urban locations and those serving more ethnically diverse populations also reported lower experience ratings. Sensitivity analyses confirmed result robustness.

Conclusion
This national cross-sectional study found that greater telephone consultation use is significantly associated with lower patient-reported experience. Alignment with existing evidence, temporal design, and consistent model findings strengthened reliability. As global-health systems shift to digital-first care, these findings highlight the need for policies to ensure that the drive for efficiency with remote consultations does not compromise equity or quality in primary care.