The elderly face "significant and unacceptable" variations in accessing their GP services across Wales, the Older People's Commissioner has warned.
Sarah Rochira said there was "a real risk" that barriers to seeing family doctors could add to "unnecessary pressures" on other parts of the NHS.
Her comments come in a report published after a nine-month consultation.
The Royal College of General Practitioners (RCGP) said it highlighted challenges doctors faced.
The commissioner said more than 1,600 older people had taken part in the consultation, which also quizzed health professionals, charities and health boards.
The inquiry found that while many patients spoke positively about their GP services, many others voiced concerns.
- Difficulties in making appointments, which the report said could be "challenging, inflexible and unresponsive to individual needs and circumstances"
- Concerns about accessibility of buildings, with some described as a "barrier" to older people
- Too many older people found it difficult to provide feedback, or raise a concern or complaint
"I understand the significant pressures being faced by GP services and the wider primary care sector and the real challenges that these pressures can create," the commissioner said.
"But at a time like this, it is more important than ever to listen to and understand older people's experiences in order to address any concerns and deliver continuous improvements to ensure that a greater cost isn't paid further down the line."
- "We have a system of ringing for an appointment from 8am onwards. This system is INSANE. You can be re-dialling for three quarters of an hour before speaking to somebody and inevitably the appointments have all gone," Betsi Cadwaladr University Health Board
- "Getting an appointment for the same day takes around 200 redialled calls over thirty or forty minutes," Aneurin Bevan University Health Board
- "I have to ring for days before I get through - it is wearing and worrying. It's most seriously frustrating just getting the engaged tone," Cardiff & Vale University Health Board
- "The appointment system doesn't work effectively. People are queuing at the entrance from 08.15am to get an appointment that day, whether an emergency or not," Betsi Cadwaladr University Health Board
- "You have to start queuing at 8am and if it's raining there is no cover outside from the rain," Cardiff & Vale University Health Board
- "Morning after morning there are rows of patients waiting to be 'let in' so that they can make appointments, even if they are feeling quite ill and shouldn't be standing outside in the cold," Hywel Dda University Health Board
CONTINUITY OF CARE
- "Before, doctor was part of the family. Now, I don't know who it is. Will they know who I am? There is no consistency, do they talk to each other?" Hywel Dda University Health Board
- "Just another name to someone I don't know and who does not know me," Cwm Taf University Health Board
- "Lack of continuity - don't get to see the same GP so they don't have the full picture," Powys Teaching Health Board
The RCGP, which represents the family doctor profession, said it welcomed the "important report" and that it made a number of "helpful recommendations".
A spokesperson added: "It is also testament to the hard work of GPs and our teams at a time of such intense resource and workforce pressures, that the majority of our older patients are reporting good care from their family doctor."