NHS bosses in Somerset have been accused of "complacency" over patients' ability to access their local GPs.
The NHS Somerset integrated care board (ICB) has been making numerous changes to the ways Somerset's 59 GP surgeries operate in line with the government's ten-year plan for the health service.
Senior figures claimed at a meeting in Bridgwater on Thursday morning (July 2) that Somerset patients were enjoying "above average" standards of care, with a large amount of same-day appointments and a sharp rise in people using the NHS app for appointments and prescriptions.
But local councillors said more work was needed to ensure GP surgeries were delivering a consistent level of care - especially for patients who are elderly or less experienced with modern technology.
The performance of Somerset's GP services was discussed in detail at the inaugural meeting of Somerset Council's adults, health and housing scrutiny committee in Bridgwater on Thursday (July 2).
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According to the NHS GP patient survey, Somerset is "consistently in the top five nationally" for patient satisfaction, with 80 per cent of people stating they find it easy to contact their GP practice.
In terms of overall patient experience, Somerset ranks in the top ten nationally, with 77 per cent of patients rating their GP surgery as 'good' or 'very good' (compared to the UK average of 75 per cent).
Around 45 per cent of appointments requested by patients take place on the same day, with a further 40 per cent taking place within two weeks of any initial inquiry.
Luke Best, NHS Somerset's primary care manager, said that all Somerset GP surgeries were now using "cloud-based telephony", allowing patients to arrange call-backs and avoiding such a mad scramble for appointments at 8am.
Councillor Gill Slocombe, who chairs the committee, said there was "a little bit of complacency" within the NHS about access to health services - and observed that many patients were still experiencing a poor level of care.
Ms Slocombe (who represents the Bridgwater West division) said: "You say 45 per cent of appointments requested take place on the same day - I wish that were true, but I don't think that's true in the real world.
"That still means that 15 per cent of patients don't even get seen within three weeks or even longer
"Triaging is a good idea, but sometimes some people are very modest and don’t want to tell doctors how really bad they are.
"Is 59 surgeries enough? We are hearing people more and more saying they are waiting and waiting.
"Not all patients are online - we are not finding a way of looking after the patients who have no idea about what an app is. With the greatest respect, many just don't want to know."
Sukeina Kassam, NHS Somerset's director of primary care, said that the triaging system was essential to managing high demand for NHS services.
She said: "In the current day and age, and with the demand on health services, there would have to be some form of triage at the front door – otherwise we wouldn’t be able to prioritise those who needed care. It would be unrealistic."
Mr Best added: "We don’t know what the unmet demand is [for appointments], because there is no way of measuring it.
"We can only measure the appointments that took place - that is something that NHS England is working on. We don’t know what we don’t know."
Around 68 per cent of Somerset patients are currently registered on the NHS app - the equivalent of around 362,000 people, and a sharp rise from under 40 per cent in 2024.
Up to 95,000 prescriptions in Somerset are ordered through the app every month - but Councillor Lucy Trimnell (Conservative, Wincanton and Bruton) questioned why alternative provision was not in place across Somerset for those not on the app.
She said: "Lots of people aren’t able to use the app for repeat prescriptions.
"My local doctors' surgery where is absolutely superb – it offers same-day appointments where needed, I don't get any complaints, but you can no longer phone the surgery for repeat prescriptions. What is the alternative method?"
Sam Checkovage, NHS Somerset's head of general medical services, replied: "There is a counterfoil to your prescription which has tick-boxes, and you can drop it into the surgery - or your local community pharmacy can take over the ordering of your repeat prescriptions.
"Telephone requests for prescriptions are not normal process because you can’t tell who you’re talking to."
Somerset currently has the equivalent of 4.8 full-time GPs per 10,000 residents - higher than the national average (4.5) but lower than the average for the south west (5.1).
While the number of GPs has remained relatively constant over the last 12 months (399 vs 398), the number of practice nurses has declined over the same period from 227 to 13 - driven primarily by older staff retiring.
Councillor Val Keitch (Liberal Democrat, Ilminster) said: "I think if you are youngish nurse starting out, you want to see some kind of career progression.
"I suspect that if you went straight into a GP surgery, you wouldn't see the opportunities for promotion."
Ms Checkovage countered: "There is still the stereotype that in general practice, nurses will only be doing things like giving immunisations or doing dressings; actually, the career progression within general practice is much more varied than that.
"A lot of general practice nurses will end up specialising in a long-term condition like diabetes or respiratory illness - that also provides a career pathway.
"That’s why we’re trying to encourage more training to happen in general practice, because those nurses who do a placement there actually love it, and tend to gravitate to there after they come out of training."
Anyone who has had issues with their local GP practice is advised to lodge a complaint with their surgery in the first instance.
Alternatively, people can complain directly to NHS Somerset by calling 08000 851067, emailing somicb.pals@nhs.net or writing to PALS and Complaints Team, NHS Somerset Integrated Care Board, Freepost RRKL-XKSC-ACSG,
Yeovil, Somerset, BA22 8HR.
Mr Best said: "We are very aware that things aren’t perfect. We could all sit around this table and talk about personal experiences of ourselves or our neighbours when things haven’t gone quite so well."
A further update on these issues is expected to come back to the committee in October.
Ms Slocombe concluded: "I don’t wish to be negative, but I think we want better - that's the message, and I think that's fair.
"I don’t want us to be complacent. I think that we owe our population a better service.
"The service is not consistent across doctors' surgeries. What we need to do is to bring the service at every doctors' surgery up to the same standard, so that no matter where you live - rural or urban - you get the same service."
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