30 years on, has patient satisfaction improved in General Practice in the

UK?

Andrew D SmithSurvey Director

5 Nutfield Lane, High Wycombe, Bucks, HP11 2ND, E-mail: andrew.smith@patientdynamics.org.uk

Objectives

To review and replicate the patient satisfaction work that was started by Cartwright and Anderson in 19641 repeated by Prof Richard Baker2 in 1994.

Design

• The design of the research was a comprehensive literature review and the analysis of a large database of patient which contains n=476,98l individual survey forms

• Additional practice data were collected by email and postal questionnaire

Setting

• UK primary care where approximately 35,000 GPs practice in around 10,000 practices.

Participants• Over a three period 2006~2009, responses

from n=314,365 adult patients, registered with a GP. These patients had used a service from General practice in the preceding 12 months, were over 16 and complete a GPAQ survey.

• 896 practicing GPs from +300 practices gave details of their work patterns and list size.

Main Outcome Measures

• This paper adds a new dimension to the current evidence by looking at the overall response rates by the age of the patient and the ethnicity of the responder.

• Not all General Practice is the same and some patients will be more much tougher to please than others.

Results

• Patient satisfaction rates remain high and increasing slightly over time.

• Patients express a preference for smaller and more personal practices.

• The inverse of the initiatives for larger poly clinics suggested by the Darzi3 review.

Questions used to derive the mean rating scoresPractice related questions Doctor related questions

Q2 Receptionist rating Q10a Questioning about symptoms

Q3a Opening hours Q10b Listening

Q4b Waiting time for a particular doctor Q10c Put at ease

Q5b Waiting time for a any doctor Q10d Involvement in decisions

Q7b Consultation wait times Q10e Explanations

Q8a Getting through on the phone Q10f Time with doctor

Q8b Through to a doctor Q10g Patience

Q9b Seeing your usual GP Q10h Caring and concern

Q12a Nurse listening

Q12b Nurse quality of care

Q12c Nurse explanation

Q13 Overall satisfaction

GPAQ mean scores over a three year period n=314,365

Conclusion

• Patient satisfaction rates are unlikely to be a reliable indicator in to the health of General Practice

• Any financial incentives offered to improve ‘patient satisfaction’ need to be considered carefully.