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GPs buried under trusts' workload dump

Revalidation patient survey tool flags up concerns with one in ten GPs

Exclusive The GPC has called for a rethink over a 'simplistic' patient survey tool set to be used as part of the revalidation process, after an exploratory study flagged up concerns about nearly one in ten GPs.

Researchers at the University of Leicester examined consultation satisfaction questionnaires from 6,433 patients, and found that of 171 GPs who were assessed, 15 had one or more scale scores below two standard deviations of the mean, highlighting patient concerns.

The study prompted the GPC to immediately call for a rethink of the use of patient surveys in revalidation, branding them a ‘simplistic' tool for deciding whether GPs need remediation. In 2009 Pulse revealed the RCGP expects as many as one GP in seven to require retraining as part of revalidation.

The study, published in the British Journal of General Practice, assessed 6,433 consultation satisfaction questionnaires, which are already used by GPs for appraisal and are currently being assessed for use in revalidation.

While the majority of GPs performed well, more than 5% of GPs consistently fell below the mean average patient satisfaction level. Nine GPs scored less than 50% on general patient satisfaction, a measure which took into account ‘depth of relationship' and ‘perceived time' spent with patients.

Study author Professor Richard Baker, from the Department of Health Sciences at the University of Leicester and a GP in the city, said: ‘This is patient feedback that is intended to be part of an education process, not a "pass" or "fail".'

‘The question then becomes: "In the context of revalidation what should the response from the appraiser be if the feedback is not very positive?"'

The latest RCGP advice published this month said causes for concerns raised during revalidation would be taken into account by responsible officers when making revalidation recommendations.

Dr Richard Vautrey, GPC deputy chair, said: ‘This calls in to question the place of such surveys in the revalidation process.  It is important to learn from patient feedback but it is far too simplistic to try to use surveys to create a simplistic scoring system.'

But RCGP lead on revalidation Professor Mike Pringle defended the plans, and said where concerns were highlighted, appraisers and GPs would ‘come to an understanding' about what action could be taken.

‘Some GPs, because of the nature of their work, might expect to have lower scores than others,' he said. ‘For instance a locum might well have lower scores than principals in general practice who have built up relationships. ‘

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