Patient survey has gone 'seriously wrong', says top adviser
By Nigel Praities
Ministers have got the patient access survey ‘seriously wrong' according to a leading academic and architect of the scheme who claims the Government ignored calls for it to focus on continuity of care as well as access.
A Pulse investigation this week shows the patient survey has cost UK general practice £35m and that practices in the poorest areas were losing 25% more than those in the most well off areas.
Professor Martin Roland, director of the National Primary Care Research and Development Centre, who acted as an official adviser to Ipsos MORI in drawing up the controversial survey, said the survey in its current form fails to reflect the priorities of patients, who regard continuity of care as more important than access.
His comments were prompted by a study presented at a Society for Academic Primary Care meeting last week suggesting patients' perceptions of continuity of care have declined significantly since 2003.
Roland said: ‘I think the Government is wrong to focus exclusively on access. Recent evidence shows that being able to see a doctor of one's choice is more important.
‘We wanted to put more questions on continuity of care in the survey, but the Government did not think it was important – but there are lots of questions on access,' he added.
‘The Government's stated aim is to make the health service reflect what patients want and continuity of care is very important to them.'
The analysis of data from 42 practices in England using the General Practice Assessment Questionnaire – one of the surveys previously used for assessing patient views for QOF – between 2003 and 2007 recorded a drop in scores for questions on continuity of care and how often patients saw their usual GP.
Presenting the research, Dr Stephen Campbell, lead researcher and senior research fellow in primary care at the University of Manchester, said the reduction in continuity of care occurred after a ‘conveyor belt' of reforms in general practice.
‘I don't want to attribute responsibility for this, but continuity of care in terms of seeing the same doctor has decreased after 2003 and has stayed that way since,' he said.
A DH spokesperson defended the focus on access: ‘Improving patient access, being a responsive practice, is now a key part of what patients expect and general practice must continue to respond to patients' expectations,' he said.Continuity vs. access
Only two of the 47 questions in the patient survey relate to continuity of care, covering whether patients had a particular GP they prefer to see and how often they are able to see them
In contrast, 14 questions in the patient survey relate to access, with ten for access to GPs, one for access to practice nurses and three for access to out of hours GP care
Only two questions are used to determine GP pay under QOF, with both originating from questions on access: PE7 for 48 hour access and PE8 for 48 hour advance booking
Source: GP patient survey 2008/09