Appointments aren’t access: the hidden work of getting care
File(s)
Author(s)
Jerjes, Waseem
Majeed, Azeem
Type
Journal Article
Abstract
Primary care access is often judged by appointment supply, waiting times, and utilisation, yet patients experience access as a series of small obstacles that accumulate into delay, drop-off, and avoidable deterioration. Building on existing literature on administrative burden, treatment burden, digital exclusion, and telemedicine inequity, this commentary proposes the Access Friction Index (AFI) as a practical framework for measuring the real-world effort required to convert a health need into timely assessment, follow-up, and treatment. Drawing on recent evidence from the UK, US and other settings, it links access friction to inequities for vulnerable groups, missed screening, medication non-adherence, unplanned return visits, and avoidable hospital use. It also outlines how routine service data and electronic records could be used to identify friction hotspots—including repeated contact, mode switching, handoffs, results handling failures, and delayed pathway closure—and how primary care-community approaches such as navigation and outreach might reduce friction while improving outcomes.
Date Issued
2026-05-01
Date Acceptance
2026-05-06
Citation
Journal of Primary Care & Community Health, 2026, 17
ISSN
2150-1319
Publisher
SAGE Publishing
Journal / Book Title
Journal of Primary Care & Community Health
Volume
17
Copyright Statement
© The Author(s) 2026. Creative Commons CC BY: This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https:// creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us. sagepub.com/en-us/nam/open-access-at-sage).
License URL
Identifier
10.1177/21501319261453255
Subjects
access to care
health inequities
primary care
patient-centeredness
community health
Publication Status
Published
Date Publish Online
2026-05-16