"The majority of parents and carers are struggling to access Hertfordshire GP services for their child or the young person they care for," a review has found, leading to a raft of recommended changes to the system.

The NHS Hertfordshire and West Essex Integrated Care Board (ICB), which plans how NHS money is spent in our area, commissioned Healthwatch Hertfordshire to review access to general practice services for parents of children and young people in the county.

The independent body surveyed 231 parents and carers about their experiences at GP surgeries in towns including Stevenage, Hitchin, Letchworth and Royston.

"Most parents and carers had problems when trying to make an appointment, particularly by telephone, with many on hold for over an hour," says Healthwatch Hertfordshire's report, published this month.

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Some were "immediately told no appointments were available, even if they were looking to book an appointment weeks in advance", it says.

For those given an appointment, only 16 per cent could choose the type of appointment - phone call, video call or face-to-face - the review found.

"A large number of parents and carers felt their child or the young person they care for needed a face-to-face appointment because of their age and/or symptoms," the report, Accessing GP Services: Views from Hertfordshire’s Parents and Carers, says. "Despite raising their concerns, their request was denied and a telephone appointment given, which parents and carers felt was inappropriate and unacceptable."

One parent shared that they contacted their GP practice because their baby was having breathing difficulties. However, they were only given a telephone appointment in which the GP simply advised them to keep their baby in the same room.

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Another parent was not offered a home visit by the GP practice even though their child is on a ventilator and was showing clear signs of deterioration, Healthwatch Hertfordshire said.

A third, whose child has complex needs, was not given a face-to-face appointment despite explaining that their child is non-verbal and cannot communicate their symptoms or health needs.

"In some cases, not receiving a face-to-face appointment led to the child or young person being misdiagnosed and/or receiving inappropriate treatment for their condition or symptoms," Healthwatch Hertfordshire found.

Some parents and carers did report a positive experience when trying to make an appointment, often because they had used an online booking system and received a timely response, the report acknowledges.

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"Our engagement shows the majority of parents and carers are struggling to access GP services for their child or the young person they care for," Healthwatch Hertfordshire said.

"However, it is important to acknowledge that some parents and carers praised the support received from their GP practice."

Concluding, the report says: "The challenges faced by GP practices across the county are significant. However, most of the improvements parents and carers want to see are about the process of making an appointment, and easier access to their GP practice, rather than improving the quality of care.

"It is clear some systems currently in place are not designed to meet patient needs."

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Healthwatch Hertfordshire's recommendations include:

- Enabling a variety of access routes, including the use of online services and visiting the GP practice in person, to accompany all needs and preferences.

- Continuing to improve telephone systems to reduce delays and waiting times for patients.

- Providing greater flexibility in contact hours and opening times to account for school hours, work and caring responsibilities.

- Delivering customer care training for GP receptionists to improve their customer service and communication skills.

The ICB said senior leaders are starting to put the recommendations into action.

Dr Jane Halpin, the ICB's chief executive, said: "This survey is just one of the many ways we are working to put the voices of patients front and centre of our work so that we can support practices to implement improvements that could benefit both patients and practice staff.

"GP services remain under huge pressure and with a growing, ageing population and a national shortage of clinicians, meeting patient demand is always going to be difficult, but we are committed to supporting our patients and working with them to improve services."