RT Journal Article SR Electronic T1 English general practice in a period of change: a mixed-methods study of staff and patient perspectives JF BJGP Open JO BJGP Open FD Royal College of General Practitioners SP BJGPO.2025.0069 DO 10.3399/BJGPO.2025.0069 VO 10 IS 1 A1 Gage, Heather A1 Herron, Alice A1 Jones, Bridget A1 Bailey, Simon A1 Bates, Amanda A1 Cassidy, Rebecca A1 Marchand, Catherine A1 McKean, Emily A1 Spilsbury, Karen A1 Richards, Suzanne H A1 Campbell, John A1 Chilvers, Rupa A1 Williams, Peter A1 Brady, Phelim A1 Joy, Mark A1 de Lusignan, Simon A1 Peckham, Stephen YR 2026 UL http://bjgpopen.org/content/10/1/BJGPO.2025.0069.abstract AB Background The COVID-19 pandemic prompted widespread use of remote (telephone and online) communication in general practice in England, which exacerbated long-term pressures from staffing shortages. The public perceived problems with access.Aim To explore patient and staff perspectives on changing processes in general practice.Design & setting A mixed-methods study (patient survey and staff focus groups) in a sample of 22 general practices in England, varied by size, region, deprivation, and demography, was conducted in 2022.Method An online survey was delivered by short message service (SMS) text to adult patients at 21 practices. Data from answers to an open-ended question about patients’ experiences were analysed using summative content and thematic analysis. Virtual focus groups conducted with four categories of staff (GPs, nurses, receptionists and administrators, and practice managers) covered teamworking, roles, patient interactions, adapting to change, and workload. Data were transcribed and analysed using framework and thematic methods. Themes common to patients and staff were identified.Results Overall median survey response was 10.9% (interquartile range 9.7%–14.6%); 14 401 patient responders provided 10 348 comments, 51.2% were positive. Patient and staff perspectives overlapped in two areas. The first, ‘contact and communication’, encapsulated differing views around access. The second, ‘non-clinical roles and patient care’, concerned the allocation of appointments and the roles of receptionists. Patients reported barriers to getting timely appointments with their chosen professional while staff were seeking ways to manage the volume of communications. Use of non-clinical staff to triage appointment requests was unpopular with patients and receptionists felt clinically unqualified.Conclusion Effective methods are needed to improve patient communication with practices and access. Receptionists require recognition and training for their pivotal role.