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Independents' Day

GPs' advice sidelined

By Anna Hodgekiss

Patients are sidelining GP advice over which hospital to choose in favour of measures of clinical quality, cleanliness and travelling times.

Research by the King's Fund found 75 per cent of patients believed the 'clinical quality' of the treatment they received including length of recovery time was the most important factor when choosing a hospital.

But they would also sacrifice some degree of clinical quality if there was less travelling time involved.

In contrast, 60 per cent of patients said they would consider GP advice on a hospital, either positive or negative, to be the most important factor in choosing where to be referred.

Of GP advice that was taken, patients took more notice of negative GP recommendations than positive ones.

Better-educated patients were more likely to choose treatment at hospitals with better clinical performance, while those without formal qualifications were less concerned about clinical quality, adding to fears about widening health inequalities.

Cuts in waiting times to less than 10 weeks had no effect on the choice of hospital, while patients' poor health and a reliance on public transport led to patients remaining loyal to their local provider.

The study, by RAND Europe, the King's Fund and City University, surveyed 1,000 people across England who had been referred for elective treatment in the last five years.

Professor John Appleby, chief economist of the King's Fund and co-author of Understanding Patients' Choices at the Point of Referral, said: 'Despite everyone having the same information about the hospitals, people with less formal education were less concerned about clinical quality.

'On an overall level, we thought GP advice would be the overwhelming factor, but it seems we were wrong.

'While clinical quality was the most important factor, patients were willing to trade

off a bit to go somewhere near home or with shorter waiting lists.'

Dr Martyn Walling, a GP in Boston, Lincolnshire, said the findings did not fit with his experience of consultations.

He said: 'Patients want GP advice every time. The first thing they say to me is "What do you think, doc?".

'If it's bread-and-butter stuff like bunions, it doesn't matter who treats them, but for hips and knees they want you to recommend the best person.'

Dr Adam Greig, a GP in Bracknell, Berkshire, said youn-ger patients were often more concerned about finding the best care and consultant than their senior counterparts.

He added: 'The elderly tend to want the nearest hospital to them, usually because transport options are more limited.'

Dr David Bevan, a GP in

Upwell, Cambridgeshire, said Choose and Book was another issue confusing patient choice for patients, and it did not deliver for 'intellectually disadvantaged' people.

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