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PCT is accused of delay replacing GP

Patient satisfaction is completely unrelated to objective measures of the standard of care and PCTs should be wary of using it as a basis of payments to GPs, says research.

While the general practice assessment survey suggested patients were broadly satisfied with the quality of their care, the study uncovered dramatic variation from practice to practice in technical measures of quality.

The RCGP warned patient surveys could give 'a false sense of security' and said GPs should be careful not to be complacent.

Researchers sent surveys to 4,000 elderly patients in Essex and found the level of satisfaction with their care varied from 60 to 79 on a 100-point scale. But the level of satisfaction did not correlate with the technical measures, which varied much more markedly between practices.

Rates of flu immunisation ranged from 16 to 63 per cent, the proportion of patients whose blood pressure was adequately monitored from 51 to 95 per cent and those adequately controlled for hypertension from 39 to 79 per cent.

Up to 70 points are available to practices that have assessed patient experience with approved patient surveys and can demonstrate evidence of change.

But lead researcher Dr Mala Rao, of the London School of Hygiene and Tropical Medicine, said: 'This lack of correlation suggests the assessment survey is not adequate to be used alone as a measure of quality.

'We cannot just ask elderly people about the quality of their general practice care,' she said.

Dr Rao, who presented the research at the Society for Social Medicine conference earlier in the month, added: 'If measures of quality are to be used for ranking general practices, for payments to GPs, or for performance management other measures that specifically relate to the quality of technical care must be included.'

Dr Mayur Lakhani, president elect of the RCGP, said: 'It is important to measure patient experience and we shouldn't just dismiss it. But if patients are reporting high levels of satisfaction, how do GPs work out how they can improve things?'

Dr Lakhani said he hoped GPs could now move beyond patient surveys, although he said the general practice assessment survey was a good tool to back up technical measures.

By Emma Wilkinson

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