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More patients are saying they are “completely satisfied” with care in GP practices and health centres, with high proportions saying they are treated with dignity and listened to carefully.

This is according to a major survey of primary care services, published last week by the Healthcare Commission.

Between January and April this year, more than 69,000 people in England were asked about their experiences of GP practices and health centres and about access to dentists.

The survey, coordinated for the Commission by the Picker Institute Europe, covered topics such as access to appointments, waiting times and patients’ relationships with NHS staff.

Alongside the results, the Commission will release on its website - for the first time - a national overview with comparative scores for all 152 primary care trusts in England, the organisations that buy services from GPs and dentists.

The independent healthcare watchdog says the results will help trusts to understand the views of their patients and respond to any concerns.

In addition to showing that patients are increasingly positive about services, the results highlight that patients want better access to GPs and dentists.

They show that:

• Patients are positive about many elements of the care they received from their GP. Seventy four percent said that the main reason they went to see their GP was dealt with “completely” to their satisfaction – a slight improvement from 2005 when this was 73 percent. Patients were particularly positive about doctors’ personal skills. Ninety-three percent said they were treated with respect and dignity “all of the time”, an increase from 92 percent in 2005. Even at the lowest scoring trust, this figure was 81 percent. Eighty-three percent said their GP “definitely” listened to them carefully, up from 82 percent in 2005. Seventy-six percent of patients said they felt they were “definitely” given enough time to discuss their problem – up from 74 percent in 2005. Seventy-seven percent said they “definitely” had trust and confidence in their doctor – up from 76 percent in 2005.
• Access to GP services remains an issue, and variations were observed around the country. Patients should be able to see a GP within two working days or another primary care professional, such as a practice nurse, within one working day. Thirteen percent of respondents who had recently made an appointment reported waiting longer than the 48-hour target time because no earlier appointment was available with any doctor at their local practice. Overall, the proportion of respondents who waited two working days or less for their last appointment with a doctor rose from 74 per cent in 2005 to 75 percent this year. In the highest scoring trust for this question, 89 percent of respondents said that they were seen by a GP within two working days - but in the lowest scoring trust, this figure was just 43 percent. Furthermore, 26 percent of respondents said they were unable to book an appointment three or more days in advance. In total, 23% of patients who made an appointment felt that they should have been seen sooner than they were.
• A quarter (25 percent) of respondents said that they had at some time been put off going to their GP practice or health centre because the opening times were inconvenient for them, up from 21 percent in 2005. Younger people were considerably more likely to find opening hours inconvenient, with the figure rising to 38 percent among people aged 16 to35. Many respondents also reported difficulties getting through to their GP practice or health centre on the phone, with 55 percent saying that they had problems at least some if not all of the time.
• Patients being referred for a first outpatient appointment should be offered a choice of hospital. There were variations in the number of patients offered a choice of hospital when being referred for treatment. Nationally, 43 percent of those referred to a specialist said they were offered a choice of where they were referred to, compared with just over a quarter (26 percent) in 2005. At the highest scoring trust, 62 percent of respondents said that they were offered a choice. At the lowest scoring trust, the figure was 23 percent. It should be noted that these figures include some patients who will be exempt from the choice policy.
• Patients wanted more access to NHS dentists. The National Institute for Health and Clinical Excellence (NICE) recommends the longest period an adult should go without visiting the dentist is two years. Twenty-six percent of respondents said they do not see a dentist once every two years, and in several trusts this was as high as 43 percent. Fifty percent of respondents said they visited an NHS dentist this regularly, while 24 percent did so as a non-NHS patient. Seventy nine percent of those who did not receive NHS dentistry would like to be able to do so, with this figure ranging from 54 percent to 88 percent across trusts. Also saying this were 81 percent of those who had not seen a dentist at all in the last two years, ranging from 67 percent to 96 percent across trusts.
• Of those that wanted health promotion advice, 43 percent said they did not get the advice they wanted on diet and 44 per cent said they did not get the advice they wanted on exercise. The Commission said it was encouraged that, of patients that wanted it, a majority said they got advice on alcohol and tobacco.

Anna Walker, the Commission’s Chief Executive, said: “This survey shows the high regard that many patients have for the services at their GP surgeries. That is really good news, not least because the NHS sees the vast majority of its patients in GPs surgeries and health centres rather than in hospitals.

“However, people clearly do want to be able to see a GP more easily and at more convenient times. It was striking that some people could not get an appointment within two days and that there are variations around the country. It is clear that more people want to be able to book appointments several days ahead and that many want more flexible opening hours. In addition, a significant proportion of patients are not being offered a choice of hospital. These are issues that a modern 21st century health service really ought to be able to address.

“Access to NHS dental care is also a continuing concern and this survey shows where people are most worried about this around the country. Regular dental treatment is important for maintaining good oral hygiene. If a large proportion of people do not receive this treatment regularly, we could be facing a significant national health problem in years to come.

“Publication of this survey, with comparative information, will help trusts and GPs to address patients’ concerns. In assessing the performance of primary care trusts, we at the Commission will take account of patients’ views and ask questions about the issues raised. We recognise the national concerns about dental care and we will be highlighting gaps where they occur.”

More information on the National survey of local health services 2008

Information on the Healthcare Commission

The Healthcare Commission is the health watchdog in England. It keeps check on health services to ensure that they are meeting standards in a range of areas. The Commission also promotes improvements in the quality of healthcare and public health in England through independent, authoritative, patient-centred assessments of those who provide services.

Responsibility for inspection and investigation of NHS bodies and the independent sector in Wales rests with Healthcare Inspectorate Wales (HIW). The Healthcare Commission has certain statutory functions in Wales which include producing an annual report on the state of healthcare in England and Wales, national improvement reviews in England and Wales, and working with HIW to ensure that relevant cross-border issues are managed effectively.

The Healthcare Commission does not cover Scotland as it has its own body, NHS Quality Improvement Scotland. The Regulation and Quality Improvement Authority (RQIA) undertakes regular reviews of the quality of services in Northern Ireland.

Further information:
The Commission’s press office on 02074480868, or 07795 548541 out of office hours