Exploring the relationship between provision of online consultations in general practice and patient experience: an observational study in England.

Abstract (English)

BACKGROUND: The NHS Long Term Plan prioritised digital transformation, including the rollout of the NHS App and online GP consultation. Since then, Online Consultations (OCs) use has expanded rapidly, accelerated by the COVID-19 pandemic. These systems enable patients to contact their general practice digitally for clinical or administrative queries. AIM: As patient satisfaction is a key indicator of primary care quality, this study aimed to understand how OC use influences satisfaction, particularly as OC services become mandatory under the forthcoming GP Contract. METHOD: We analysed 2024 data on monthly online appointment volumes from practices in England, linked with 2025 GP Patient Survey responses to assess relationships between OC use and patient satisfaction. Measures included overall satisfaction, ability to see a preferred GP, acceptability of appointment wait time, and whether patient needs were met. We used linear regression models controlling for practice characteristics such as OC system, workforce, deprivation, and patient demographics. Sensitivity analyses examined variations by practice usage, deprivation level, and OC system type. RESULTS: Our sample included 4691 practices, averaging 352 monthly online consultations versus 4621 face-to-face appointments. Higher OC rates per 1000 registered patients were significantly associated with lower overall satisfaction and a reduced likelihood of seeing a preferred GP. No significant association was observed between OC use and perceived wait times or whether patient needs were met. CONCLUSION: At a population level, increased reliance on OC system may reduce overall patient satisfaction. Further research is needed to identify which types of online consultations work best and for whom.