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Patient satisfaction in general practice drops to record low levels as ‘intense pressures’ show

by Anviksha Patel
7 March 2019

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A quarter of patients are dissatisfied with general practice – the lowest level since data was first collected in 1983 – a new analysis of a national survey has claimed.
The King’s Fund and Nuffield Trust’s analysis of the 2018 British Social Attitudes (BSA) survey revealed only 63% of people taking part were satisfied with GP services.
But primary care leaders have stressed the ‘intense resource and workforce pressures’ facing general practice and noted public satisfaction could have been far lower were it not for the hard work of practice teams.
Satisfaction with the NHS as a whole has fallen to its lowest level since 2007 – dropping three percentage points to 53% in 2018.
Almost one in four (24%) of those surveyed reported feeling dissatisfied with their GP service, a doubling since 2009. A total of 13% said they were neither satisfied nor dissatisfied with the service.
Long waiting times for appointments

This year’s survey revealed that the main reason people were dissatisfied was the long time it takes to get a GP or hospital appointment.
The Nuffield Trust’s director of research and chief economist John Appleby said: ‘Looking back over 30 years of the BSA survey, we know that quick access to NHS care is very important to the public.’
He acknowledged the ongoing pressures on GPs and warned that proposals in the NHS long-term plan would place even greater demands on primary care.
He said: ‘This [result] may reflect continued strain on general practice, with mounting workloads and staff shortages and the evidence shows that people are finding it harder to get appointments than before.
‘The NHS long-term plan expects even more of general practice – these problems will need to be addressed quickly if that vision is to be made possible.’
Appleby called the recent announcement of funding for 22,000 additional practice staff working in networks as part of the new GP contract ‘bold suggestions’ but said there would be no immediate impact on waiting times for patients.

Investment is ‘vital’
Co-chair of the Practice Management Network Steve Williams said there is ‘no simple solution’ to tackling long appointment waiting times.
He said: ‘We have been dealing with improving access for years. We have increased the number of appointments, but demand coupled with a shortage of GP staff can often make the problem seem worse.’
Mr Williams added: ‘It is true that “investment and evolution” will tackle part of the resourcing of additional clinical staff, but how this will be allocated within the primary care networks is yet to be determined.
‘Investment in staff training and development is vital. We need a broader skill mix within the whole practice team. This team needs the capability and capacity to deal with both access and continuity of care.’
BMA chair Dr Chaand Nagpaul said NHS workers are ‘working harder than ever before’ but are ‘fighting a tide’ of rising patient numbers, poor staffing, lack of space and a lack of investment.
He added: ‘Given this backdrop the levels of satisfaction could have been lower, and I believe it’s almost certainly the dedication of staff in the NHS that prevents this.
‘NHS staff are simply not being given the tools and support to give patients the care they deserve.
We need the Government to urgently address this in the immediate term and to also ensure that beyond the long-term plan headlines there is a clear road map that gives the NHS the staff, resources and services it desperately needs.’
Unsustainable conditions
RCGP chair Professor Helen Stokes-Lampard said: ‘We know that general practice is currently facing intense resource and workforce pressures, and while GPs are working incredibly hard to combat these, we understand that many patients are still waiting too long to see their doctor – something we find just as frustrating.’
She highlighted that NHS England’s most recent GP patient survey found 84% of patients registered at a GP practice rated their overall experience as ‘good’.
She added: ‘This demonstrates the hard work and dedication of GPs and our teams, who are seeing more than a million patients a day across the country. But working under these conditions simply isn’t sustainable for us, or ultimately, our patients.’
Last week, a study showed four in 10 GPs want to leave the profession in next five years, stating work intensity and workload as the main factors for leaving.
The ongoing workforce crisis in practices was said to hinder the Government’s plan to move hospital care into practices, a report revealed earlier last month.
Meanwhile, a BMA survey of English practices last month found only half of practice buildings are fit for purpose.
A version of this story was originally published on our sister publication Pulse.
Additional reporting by Costanza Pearce.