Sociodemographic variation in the association between modes of access and patient experience of primary care: a retrospective cross-sectional patient-level analysis of the General Practice Patient Survey in England in 2023

Background Patient experience is a key indicator of healthcare quality. Access to general practice (GP) has shifted with increasing use of digital tools for contacting practices and more remote consultations. These changes may improve patient experience, but unequally across sociodemographic groups. This study examines how patient experience of GP varies by access mode and sociodemographic characteristics. Methods Retrospective cross-sectional analysis of 759 149 responses from the 2023 GP Patient Survey in England. Mixed-effects logistic regression was used to examine associations between patient experience outcomes—appointment booking and healthcare professional communication—and access modes (online, telephone, in-person), adjusting for sociodemographic factors and practice-level clustering. Results Online-only appointment booking methods were associated with a better experience of making an appointment (OR=1.14, 95% CI 1.11 to 1.17; p<0.001) than traditional booking methods. All patient groups, except older adults and those not reporting male or female gender identities, reported better experiences with online-only appointment booking. Inequalities narrowed by age and ethnicity, with greater improvements for younger, Asian and mixed ethnicity patients, but widened for gender as non-binary and other identities reported poorer experiences. Remote consultations were associated with a poorer experience of healthcare professional communication (OR=0.52, 95% CI 0.51 to 0.52; p<0.001) compared with face-to-face. This trend was consistent across all groups, with differences between most and least positive groups reducing for gender but remaining similar for deprivation, ethnicity and age. Implications Digital tools are associated with more positive experiences when contacting GP and may help reduce sociodemographic disparities, especially among groups who traditionally report poorer experience. Conversely, remote consultations are associated with worse experiences of healthcare professional communication. These patterns highlight the need for tailored approaches that offer choice across access modes, considering clinical need, urgency and patient preferences. Training for healthcare professionals should include remote communication skills. These insights can inform policies and service design aimed at modernising primary care while promoting equity.