Access all areas? An area-level analysis of accessibility to general practice and community pharmacy services in England by urbanity and social deprivation

Abstract

Objectives(1) To determine the percentage of the population in England that has access to a general practitioner (GP) premises within a 20 min walk (the accessibility); (2) explore the relationship between the walking distance to a GP premises and urbanity and social deprivation and (3) compare accessibility of a GP premises to that of a community pharmacy—and how this may vary by urbanity and social deprivation.DesignThis area-level analysis spatial study used postcodes for all GP premises and community pharmacies in England. Each postcode was assigned to a population lookup table and Lower Super Output Area (LSOA). The LSOA was then matched to urbanity (urban, town and fringe, or village, hamlet and isolated dwellings) and deprivation decile (using the Index of Multiple Deprivation score 2010).Primary outcome measureLiving within a 20 min walk of a GP premises.ResultsOverall, 84.8% of the population is estimated to live within a 20 min walk of a GP premises: 81.2% in the most affluent areas, 98.2% in the most deprived areas, 94.2% in urban and 19.4% in rural areas. This is consistently lower when compared with the population living within a 20 min walk of a community pharmacy.ConclusionsOur study shows that the vast majority of the population live within a 20 min walk of a GP premises, with higher proportions in the most deprived areas—a positive primary care law. However, more people live within a 20 min walk of a community pharmacy compared with a GP premises, and this potentially has implications for the commissioning of future services from these healthcare providers in England.

Spatial Accessibility of Primary Care in England: A Cross‐Sectional Study Using a Floating Catchment Area Method

“…reported substantial geographic differences with a higher GP accessibility in urban areas: 94.2 percent of urban households versus 19.4 percent of rural households with access (Todd et al. ). Although we also found large differences between urban and rural areas, we did not document such striking differences in GP access since we used a continuous accessibility measurement rather than a dichotomous measurement.…”

“…Hence, there is a need for reliable and accurate assessments of the spatial access to GPs across England. Currently, the investigation of spatial accessibility on a national scale is limited to simple measurements such as physician-to-population ratios (PPR) or the number of GPs within a fixed catchment area (Todd et al 2015). However, PPRs do not account for border crossing, are blind to variabilities within bordered areas, do not incorporate distance, and are fixed to administrative boundaries.…”

General practitioners in German metropolitan areas – distribution patterns and their relationship with area level measures of the socioeconomic status

“…Furthermore, using airline distances instead of time distances, represents a distance measurement simplification and therefore a loss of accuracy must be assumed. However, airline distances have also been used in similar research [21]. …”

Tele-pharmacy in rural Scotland: a proof of concept study

“…However, people living in remote and rural areas may not have easy access to pharmacy services and may resort to unnecessary GP consultations, or travel long distances to access a community pharmacy . This represents a source of inequality in the provision of health care in the UK…”