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A question of evidence

The two questionnaires GPs have to use if they wish to gain the 70 QOF points on offer for ‘measuring patient satisfaction’ may do the task they are designed for. Or they may not.

The two questionnaires GPs have to use if they wish to gain the 70 QOF points on offer for ‘measuring patient satisfaction' may do the task they are designed for. Or they may not.

There is no way of knowing because no research to assesses their reliability has been carried out.

Similarly, the questionnaires may perform the same for one GP as another and from one patient to another. Or they may not. Again, nobody knows.

The GP researchers who looked at the evidence on the IPQ and GPAQ are damning, in their dry academic way. Validation of the questionnaires is, they say, ‘suboptimal'. It is, they add, ‘not clear that they measure satisfaction at all'.

It is an archetypal example of the evidence-free zone that surrounds Government health policy when a popular-sounding idea chimes with its political prejudices.

Telephone consultations

By sharp contrast, clinical areas of the QOF are subjected to rigorous scrutiny, which sometimes sees apparently good medicine rejected for lack of evidence.

Take telephone reviews for asthma – barred so far because the evidence has not been watertight that they could perform as well as face-to-face consultations.

But this week a second GP team produced the strongest evidence yet on the benefits for patients and doctors of review by phone.

So, let's see the points for patient satisfaction reassigned to something useful, and a telephone consultation installed as an acceptable way of reviewing a patient's asthma.

That's what the evidence says.

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