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Ellyn Gattlin, national transformation lead at X-on Health, explains why staff buy-in and community are the real drivers of accessible GP services.
Improving access to general practice isn’t a technology problem, it’s a people problem. Yes, digital tools matter. Intelligent triage matters. Data-driven decision-making matters. But none of it works, safely or sustainably, without the workforce fully behind the change and a community of patients who understand how to use the access points available to them.
I spend a lot of my time looking closely at the patient journey: how patients try to reach their practice, what friction slows them down, what options they’re offered, and how digital tools can help. What I see, time and again, is that practices and systems procure powerful and capable technology, but if their staff aren’t equipped, engaged and aligned around the why, and if patients aren’t educated on the how, the potential benefits can be diminished.
Digital transformation is not just about deploying the correct tools. It’s about building trust, capability and a sense of community, in both staff and patients.
When we talk about access, to practice managers, receptionist teams and patients, it often means different things. Patients see access as speed and simplicity, with 86% still going straight to the phone because it feels like the most direct route to a GP. For clinicians and practice managers, access is about orchestrating multiple routes to provide options, telephony, chatbot, online consultation, NHS App, in addition to signposting to other relevant local services, without overwhelming staff or compromising safety.
Modern general practice gives patients more access points than ever, but the real question is how well those channels are being used. Tools such as Surgery Connect already allow patients to check or cancel appointments or request a callback. And with AI-powered digital navigation, 20–30% of incoming demand can be redirected to pharmacy, community services or self-serve options. But technology only creates value if the workforce understands it and the patient community trusts it.
Lack of awareness and education as a barrier
A surprising percentage of patients who call the practice simply don’t need to. They could self-serve, they could go to a pharmacist, they could submit a request online, or they could use the NHS App. The barrier isn’t unwillingness, it’s a matter of awareness and understanding the benefits of the various tools available.
Other industries solved this long ago. Retailers don’t assume customers naturally know or actively make an effort to find out about new services, they market relentlessly, but healthcare doesn’t have that luxury. We cannot email every resident each time we introduce a new feature. Instead, we need to rely on repeated, simple, ongoing education every time a patient touches the system, whether that’s on the phone, online, or in person. If we want demand to flow to the right places, education is non-negotiable.
Much has been said about digital exclusion, but it’s evolving fast. Patients aren’t just unsure or hesitant about digital, they can also be priced out of it. As people sacrifice broadband in the cost-of-living crisis, digital-first models risk leaving entire demographics behind. And literacy issues remain a major factor; for many patients, speaking to someone on the phone is simply their only comfortable option.
That’s why access must be rooted in choice, not ideology. Digital-only doesn’t work, digital-when-wanted does.
Choice is the foundation of patient satisfaction. If we give people multiple access points, communicate with them clearly, and let them choose the approach that best fits their lifestyle and works effectively, that’s how we build trust.
Staff pressures create the perfect storm behind poor access
Receptionist teams are the backbone of general practice, and many are at capacity. Workforce shortages, sickness spikes, seasonal demand and the legacy of pandemic burnout all reduce capacity precisely when demand is booming.
Digital tools, when used well, can relieve strain, not add to it. But here’s the catch: the workforce needs to understand what the tools are for, how they improve flow, and how to deploy them safely. Too often, partners or business managers procure tools without bringing the whole team along or empowering them in the process.
Digital adoption isn’t just about training; it’s about staff feeling ownership and understanding their impact. I’d recommend that practice managers share the data delivery figures with their teams, including call volumes, abandonment rates, digital uptake, and unnecessary contact diverted away. Show teams that their use of digital tools is changing the picture because people buy into what they understand and will naturally want to help.
A recent Management in Practice survey exposed something we’ve known for a while: open online consultation forms without intelligent triage are a clinical risk. Urgent symptoms such as chest pain and breathing difficulties are routinely being submitted through “non-urgent” online forms, sometimes not seen until the next day. That is not a digital success story. It’s a digital delay.
Online consultation tools must be managed intelligently. They must triage, not just capture. Patients cannot reliably distinguish urgency, and we should not expect them to. Access isn’t about opening more doors; it’s about opening the right ones safely.
If practice managers want staff to buy in, they must see the impact in real data. Telephony response times, call abandonment rates, digital uptake, DNA rates, friends and family test scores. These metrics don’t just tell you what’s happening, when shared in a meaningful way, they also tell staff why every small change they make matters and adds up to the bigger picture.
Show a reception team that 25% of calls were people who didn’t need to call at all. Show clinicians how intelligent triage reduces unsafe submissions. Change becomes real when it becomes measurable.
The workforce is the real driver of digital transformation
There’s no digital transformation without workforce transformation. It’s often not because staff are resistant to change, but because they’ve lived through years of being overwhelmed. They’ve seen tools come and go, they’ve seen initiatives launched without consultation, and they’ve felt the consequences when tools are launched without training or clear workflows.
Retention concerns sometimes make practices reluctant to invest in training, but short-term thinking creates long-term pain. When people are equipped and confident, workload drops, patient satisfaction rises, and staff stay longer. As leaders, our job is to build cultures where staff feel empowered, not bypassed.
Better access isn’t delivered simply with improved tools. They are part of the process, but in reality, it’s delivered by teams and by communities of patients that trust those teams.
If we want truly accessible GP services, we must build staff confidence in digital tools through real training and real data; continuously educate patients on the access points available to them; use intelligent triage to keep patients safe and protect staff capacity; offer choice as a core principle of access; and create a culture where staff understand impact, not just process.
When staff feel engaged and patients feel informed, digital transformation stops being something practices have to do and becomes something they own.
We’re entering an era where digital-first will become the norm, but that future will only succeed if we carry both our workforce and our communities with us.
If we get staff buy-in right, access improves. If we build community understanding, demand flows safely. And if we get both right, we can finally move from compliance to confidence, and deliver the accessible, safe and patient-centred primary care system the NHS deserves.
