Who are frequent attenders in primary care?

The average patient visits their GP surgery 3.3 times per year but there are a group of patients who make a disproportionately higher number of visits to GP clinics – often coined ‘frequent attenders’.

Frequent attendees visit their GP five times more than other patients. Recent studies have shown that consultations between frequent attenders and GPs increased from a median of 13 in 2000 to 21 in 2019 and from 27 to 60 with other primary care HCPs such as nurse practitioners and physiotherapists.

But why does this matter to you and your clients?

We all know that the more frequently an advert is viewed by someone, the more likely they are to remember and recognise the brand or product being advertised. Increased frequency also improves message comprehension, behavioural influence, and long-term brand building.

That’s why targeting frequent attenders in primary care could be a great way for advertisers to enhance brand visibility and engagement and, ultimately, drive desired consumer actions.

So, who are the people who turn up all the time and spend hours in a waiting room every month? Whilst you may have some ideas (and stereotypes) sometimes it’s not who you think it is.

People who attend GP practices on a very regular basis are usually seen as the same ‘type’ – elderly and/or with multiple conditions (co-morbidities). This is true for the most part but evidence from Europe also indicates that frequent attenders are more likely to be female, have more social and psychiatric problems, take more drugs for mental illness and have more medically unexplained symptoms.

Common health conditions, that ultimately create the need to visit in the first place, tend to be mental health disorders, hypertension (high blood pressure), diabetes, respiratory issues (such as COPD or Asthma) chronic pain, heart disease, obesity, and gastrointestinal disorders. We will go into more detail on this later on.

There is also a tendency for individuals with lower socioeconomic status to attend GP surgeries more frequently due to a higher prevalence of chronic health conditions, lower health literacy (so more likely to seek medical attention for minor symptoms or concerns) and finally socioeconomic factors such as stress, unemployment, housing instability, and social isolation which can impact physical and mental health outcomes.

One in four face-to-face consultations in primary care are for children and their parents. Infants and preschool children have the highest visit rates of any age group due to a combination of routine visits, common childhood illnesses, vaccination appointments, parental concerns and the need for ongoing support and guidance in parenting.

Children, especially infants and toddlers, are also exceptionally prone to illnesses such as colds, ear infections and stomach bugs but parents, especially first-time parents, are far more prone to being anxious about minor issues that might not need to be treated by a HCP at all.

Away from the gloomy pits of Google ‘rabbit holes’, fear-mongering ‘Netmum’ parent forums and overbearing in-laws, primary care provides a trusted resource for parents to address concerns and receive reassurance and guidance.

On the other side of the age spectrum, the unique healthcare needs of older adults (over 60) including age-related health concerns, complex medical needs and health education, contribute to frequent attendance at GP practices.

As discussed in more detail below, as people age, they are more likely to experience a range of health conditions, including chronic diseases such as diabetes, arthritis and heart disease. Older adults also require treatment for and support for age-related conditions such as vision and hearing impairment, mobility issues, falls, cognitive decline, and frailty.

Above all, older people value the socio-emotional behaviours of GPs in consultations. For example, new research suggests that thousands of individuals over the age of 65 visit their GP each year just because they are lonely.

Long-term conditions, also known as chronic illnesses or chronic diseases, comprise the biggest burden on the NHS, involving more than half of all GP consultations.

More than 15 million people in England have one or more long-term physical conditions and their prevalence rises with age, affecting 50% of people by the age of 50 years and 80% by the age of 65 years.

People with long-term health conditions often require frequent visits due to the need for medication reviews, check-ups for symptom monitoring and screening for additional health issues (as they are at higher risk of developing complications or comorbidities associated with their condition.)

Living with a long-term health condition can have significant psychosocial impacts, including stress, anxiety, depression, social isolation, and adjustment difficulties. In fact, research shows that people with long-term physical conditions are more than twice as likely to develop mental ill-health. As a result, many sufferers also seek emotional support when visiting a GP surgery to cope with the challenges of managing their condition and its impact on their daily lives.

A common long-term health condition, running through all age groups, ethnicities, and economic statuses of frequently attending patients is mental health.

Ranging from alcohol dependencies to anxiety, two in five consultations in primary care are for mental health^[1] and 90% of those are dealt with entirely within primary care. In addition, 30% of people who see their GP for a physical health issue have a secondary mental health component to their illness.

3 in 4 people living in the lowest household income bracket report mental health problems and this figure has been exacerbated by the recent cost of living crisis, with more patients than ever turning to their local primary care setting for advice on financial issues as well as physical problems.

Recent studies on health inequalities have also shone a light on maternal mental health in the UK, with one in five mothers suffering from mental health issues during pregnancy or in the first year after childbirth.

If your target audience fits in with one (or more) of the frequent attender groups in primary care, then integrating this environment as part of your overall marketing strategy could be a great way to reduce ad wastage, enhance brand visibility and engagement, and ultimately drive desired consumer actions.

But what are some top tips for a successful execution?

• Be issue-led not brand-led – across the board, frequent attenders are characterised by the distinct need for help. Their presence in a GP surgery is a purposeful one, they certainly haven’t ended up there by chance. Whatever group a frequent attendee is in, they are looking for solutions and guidance on their issue and if you can present that to them in a patient-centric format, then you’re fulfilling that need in the place they need it the most.
• Use the right format(s) – age, health literacy, cultural background and health issue all have a bearing on the most suitable format(s) for reaching a frequent attendee. Those in an older age bracket might prefer a printed leaflet over a digital advert. If you’re trying to drive awareness of a symptom, then posters might be your preferred vehicle for messaging.
• Understand your audience – do not treat frequent attenders as a homogenous group. They may all have health issues in common or be from similar age groups, but there will be specific nuances too that should have a bearing on the imagery, references and even language you use.

Frequent attenders in primary care are primed for health and wellness messaging. Not only is their presence in this OOH environment purposeful but it’s also likely due to the need for a specific health or wellness solution. Aligning your product or service with that need is surely a solid marketing tactic to consider for yourself or your clients.

At IDS Media we have a wealth of experience in health and wellness campaigns for primary care patients and HCPs, over the years we’ve seen it all!

You might want to browse our website for case studies, guides and further information on the best way to approach an upcoming campaign but if you’d rather speak to us directly then we’d be more than happy to talk through some options. Please fill in the contact form below and one of our team will get in touch.