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General practices in England where patients have reported difficulty getting to see a doctor have been told to improve their services.
Most patients in England are happy with their ability to get an appointment to see a GP, show the results of the biggest ever survey about access to GPs commissioned by the Department of Health. But there are pockets around the country where retaining GPs remains a problem, and some communities are less satisfied with their experience of accessing general practice.
Areas in which there are problems of access are being asked to produce local action plans to improve their services, and primary care trusts have been told by the department to use their existing powers to invite new providers to offer high quality responsive services for patients.
Alan Johnson, the health secretary, who announced the measures this week, said, “I am particularly concerned about areas of deprivation where there is greater need for GP services, but fewer [services] available compared to more prosperous parts of the country. All patients in this country, no matter where they live or what their background, should enjoy first class primary care services. I want to see more convenient opening hours and more GPs in deprived and less well served areas.”
Findings from the survey, which involved 2.3 million completed questionnaires out of 5.2 million sent out, a response rate of 44%, show that 86% of patients were satisfied with their ability to get through to their doctor's surgery by telephone. In addition, 86% of people who needed to see a GP quickly said that they could do so within 48 hours, and 75% said that they could book ahead for an appointment.
Further results showed that 88% of patients could make an appointment with a particular doctor, and 84% were satisfied with the current opening hours of their practice. Out of those people who were not satisfied with when their practice was open, nearly half (46%) wanted it to open on a Saturday, and 26% wanted to be able to see their doctor on a weekday evening.
Average performing practices, with about 6000 patients, stand to earn an additional £11700 (€17000; $24000) from the survey.
But the department has said that certain deprived areas still have too few doctors. For example, last year Barking and Dagenham had 43 GPs for every 100000 people, compared with 88 in Northumberland and the average of 61 for England.
The survey also shows that black people and people from and other ethnic minority communities are 20% less satisfied with their experience of GPs than white patients. To resolve this problem Mr Johnson has asked Mayur Lakhani, chairman of the Royal College of General Practitioners, to chair a group to look at what is causing the dissatisfaction.
Lawrence Buckman, chairman of the BMA General Practitioners Committee, has questioned the need for the costly survey.
“You have to ask: was it really a good use of scarce NHS money to spend upwards of £11m to prove it [patient satisfaction with GP services] yet again? Obviously we would want the satisfaction figures to be even higher. Family doctors want to meet the needs of their patients, and with their teams work hard to do so,” he said.
Earlier this year, the committee criticised the government's introduction of an additional question into the survey of GPs' patients, which it said was biased. The extra question suggested reasons why patients might be dissatisfied with opening hours, such as not being open at weekends or weekday evenings, neither of which were resourced under the national GP contract.
Dr Buckman said, “It has always been possible for primary care organisations to offer the extra resources needed to extend general practice into longer hours to pay for the nurses, receptionists, doctors, and diagnostic facilities needed to open the surgery. Very few primary care organisations have chosen to spend their limited patient resources in this way.
“The danger is that switching normal opening hours away from the daytime to evenings and weekends might please some patients who are out at work all day, but would take appointments away from those who use their local surgery most—patients with long term conditions and parents with young children. All patients are important, but we must not penalise the most needy among them.”
In a separate survey of patients about choice, which was completed by nearly 270000 patients referred for specialist care, 94% of respondent said that their GP had talked to them about a choice of hospital.
GP Patient Surveys: Your Doctor, Your Experience, Your Say is available at www.dh.gov.uk.