# Older Reviews Versus Recent Reviews This note asks a simple question: What looks genuinely older in the complaint corpus, and what looks more recent? I used the rebuilt review index and split low-star reviews into two complaint-heavy windows: - `older`: estimated `2016` to `2019` - `recent`: estimated `2022` to `2026` I left out `2020` and `2021` as transition years. That gives: - `1,397` older `1` and `2` star reviews - `10,417` recent `1` and `2` star reviews The dates are still estimates from Google's relative timestamps, not exact publication dates. But they are good enough for a pre-pandemic versus post-pandemic language split. ## Headline The strongest result is still continuity plus layering. Most of the familiar complaints in the older reviews are still here in the recent ones: - the `8am` rush - not getting through on the phone - no appointments left - rude or obstructive reception What changes more clearly is the route through which patients experience those failures. The recent reviews add a much thicker layer of complaint language about: - online forms - named digital systems like `AskMyGP`, `PATCHS`, `eConsult`, `Accurx`, and the `NHS App` - triage as a gate - telephone-first or callback-first handling - difficulty getting face-to-face care as such So this still does not read like a new problem replacing an old one. It reads like the same old access failures, with extra digital and remote layers added on top. ## What Did Not Go Away The bigger corpus makes this even harder to deny. The core complaints are long-running. ### The `8am` scramble is still there - `59` older low-star reviews, `4.2%` of the older low-star set - `552` recent low-star reviews, `5.3%` of the recent low-star set Older example: > "Ring 96 times in a morning at 8am as advised to be told no appointments." > Jessica McClelland, `The Bolton Family Practice`, `7 years ago` Recent example: > "I’m not allowed apparently I need to phone at exactly 8am if I want even a chance" > joshua covus, `Albion Medical Practice`, `a month ago` That is not a vanished pre-pandemic complaint. It is still one of the basic ways patients describe access now. ### "No appointments" remains a core complaint - `84` older low-star reviews, `6.0%` - `564` recent low-star reviews, `5.4%` Older example: > "You can never get an appointment when you need one" > older low-star review, `Culcheth Medical Centre`, `7 years ago` Recent example: > "After saying what l thought in a previous comment, l have now registered at another surgery" > Andrew James, `Padgate Medical Centre`, `Edited 3 days ago` The wording shifts around the edges, but the complaint itself is stubbornly familiar. ### Rude or obstructive reception is also persistent - `161` older low-star reviews, `11.5%` - `1,057` recent low-star reviews, `10.1%` Older example: > "Receptionists are rude and it takes many weeks to get an appointment even if it’s an emergency." > older low-star review, `Corkland Road Medical Practice`, `7 years ago` Recent example: > "The reception staff are very rude and unprofessional." > lisa wiswell, `Huntley Mount Medical Centre`, `a month ago` So the older-versus-recent picture is not a story of rude reception disappearing into slicker systems. It is still part of the same access story. ## Older Complaints That Fade Rather Than Vanish This is where the earlier report mostly still holds up, but the larger corpus makes the wording cleaner. I could not find many strong older complaint families that truly disappear in the recent era. What I did find is a set of more physical, on-site, pre-digital complaints that feel relatively more at home in the older reviews, even though they do still show up later. ### Walk-in-centre frustration - `28` older low-star reviews, `2.0%` - `114` recent low-star reviews, `1.1%` Older examples: > "Arrived for walk in centre then told to come back at 1pm then when people arrived at 2pm they said they had no more walk in centre appointments." > Debra Farricker, `Hawthorn MC`, `7 years ago` > "Waited 3 hours for the walk in centre and still didn't get seen" > Mohamed Zifar, `Hawthorn MC`, `9 years ago` Recent reviews still mention walk-in centres, but more often as somewhere they are sent away to, or bounced back from, rather than as the main on-site queue itself. ### Waiting-room and in-building delay complaints - `28` older low-star reviews, `2.0%` - `116` recent low-star reviews, `1.1%` Older example: > "had an appointment for 10:50am wasn't seen till 11:10am" > older low-star review, `Great Lever One`, `7 years ago` This kind of complaint still exists, but it feels less central than it used to. Older complaints more often sound like patients are already in or near the building. Recent complaints more often happen before they even get that far. ## What Is More Clearly Recent This is where the bigger corpus sharpens the report most. ### Named digital gateways are genuinely recent complaint language - `0` older low-star reviews - `148` recent low-star reviews, `1.4%` That is the cleanest recent-only shift in the whole pass. Examples: > "They do not respond to emails, and AskMyGP is always closed." > Joey Howard-White, `Tower Family Healthcare`, `2 years ago` > "AskMyGP could be better as it fills up really quickly, usually by 8am." > Alan White, `Red Bank Group Practice`, `a month ago` The old complaint was often "I cannot get through." The newer complaint is often "every route is shut at once." ### Online-form gatekeeping becomes a proper complaint family - `1` older low-star review, `0.1%` - `112` recent low-star reviews, `1.1%` Recent examples: > "Online form must be filled out before 10am which isn't possible for some people, and then tells you to call anyway." > recent low-star review, `Chorlton Family Practice`, `2 weeks ago` > "Using covid as an excuse about everything ... Online form is restricted opens at 7am." > Syeda Khanum, `Donneybrook Medical Centre`, `4 years ago` This is one of the clearest changes in the corpus. Patients now complain not just about delay, but about being pushed into a system that fills up early, gives no answer, or simply loops them back to the phone. ### Triage becomes a thing patients have to get through - `4` older low-star reviews, `0.3%` - `89` recent low-star reviews, `0.9%` Recent example: > "Wanted to see a doctor ... fill out the triage form hoping i wound get an appointment. But all I’ve got is some cream sent to boots." > recent low-star review, `Manor House Surgery`, `a day ago` That is a different kind of complaint from older front-desk or walk-in frustration. The patient is now talking about a filtering process before care is even properly in reach. ### Telephone consultation and remote-first handling rise sharply - `10` older low-star reviews, `0.7%` - `124` recent low-star reviews, `1.2%` Recent example: > "I waited 40 minutes for a telephone consultation ... No call." > recent low-star review, `Market Street Medical Practice`, `3 weeks ago` This is another strong change in complaint shape. The service is not only hard to reach. It is more often described as remote, delayed, and callback-driven. ### Face-to-face care becomes a complaint topic in its own right - `5` older low-star reviews, `0.4%` - `244` recent low-star reviews, `2.3%` Recent examples: > "Very difficult to make an appointment, expected to be in all day for a phone call, difficult to arrange a face to face appointment" > john clarke, `Barlow Medical Centre`, `3 years ago` > "Get told to call reception for face to face appointment reception revert us back to online form." > Syeda Khanum, `Donneybrook Medical Centre`, `4 years ago` That does not mean older patients did not want face-to-face care. It means the complaint language changes. In the newer reviews, face-to-face access itself has become something patients feel they have to win. ## What The Shift Really Looks Like The era split is not telling us that the old problems went away and new problems appeared from nowhere. It looks more like this: ### 1. The old bottlenecks stay Patients still complain about: - phones - appointments - being told to try again tomorrow - rude reception - going round in circles ### 2. The newer system adds extra gates Recent reviews add: - online form closures - app-based dead ends - named digital systems - triage - callback and telephone-consultation waiting - the extra hurdle of getting face-to-face care ### 3. The point of failure moves further upstream Older complaints more often sound like: - I turned up - I waited - I was told to come back - I sat there for hours Recent complaints more often sound like: - I filled in the form - the form was closed - the app had nothing - I was waiting for a callback - I could not get a face-to-face appointment That is the key change. The struggle now more often happens before the patient reaches the room, the desk, or the clinician. ## Bottom Line The strongest result here is still continuity plus layering. There are very few older complaint types that truly disappear from the recent reviews. The core access complaints are stubborn and long-running. What changes in the recent reviews is the route through which patients experience those same failures. The newer complaint language is much more about: - digital gatekeeping - app and form dependency - triage - remote-first handling - the extra step of having to secure face-to-face care So the newer corpus does not read like a clean replacement story. It reads like the same old access failures, with a new digital layer added on top.