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Third of patient survey results statistically unsound, admits minister

By Nigel Praities

Exclusive: The new health minister for primary care has admitted the patient survey results for more than a third of practices lie outside accepted statistical limits.

In an exclusive interview with Pulse, Mike O'Brien defended the patient survey as ‘statistically robust' but revealed thousands of practices would have grounds for appeal if they have lost money.

Mr O'Brien announced that the results of 35% of practices fell outside the 7% confidence limits for the PE8 extended access question and 10% of practices fell outside this limit for the PE7 48 hour access question.

His comments came as it was revealed practices in England would lose millions because of the survey and MPs called for it to be scrapped.

Mr O'Brien hit back at fierce criticism from GPC chair Dr Laurence Buckman – who branded the survey ‘not fit for purpose' – saying it was inevitable that some practices would lose out.

'The results show the confidence intervals for payment questions are actually better than previously modelled on those from last year's survey,' he said.

‘It is inevitable that some practices will benefit more than others as a result of this, because they are potentially able to respond better to the survey than others. It depends how much focus they put into the quality of what they do.'

The minister added: ‘We believe this methodology is statistically robust and it is on the basis that previous surveys have been conducted. The survey and QOF thresholds were conducted in discussion with the GPC - perhaps Laurence [Buckman] would want to come and tell us what he wants us to do better,' he said.

The full data from the patient survey was released today, with local GP leaders calculating massive losses in some areas.

LMC leaders in Birmingham estimate a loss of £1-2m to practices in their area, based on average losses of £4-5,000 per practice.

Dr Robert Morley, executive secretary of Birmingham LMC and GPC representative for Birmingham and Solihull, said: ‘It is like practices are being fined, rather than being rewarded,' he said.

BMA leaders in Northern Ireland are also warning of ‘gross unfairness' with one practice with a list size of over 9,000 losing all of its funding for patient access.

Dr Brian Dunn, chair of GPC Northern Ireland, said: ‘Despite our repeated warnings that this survey is fundamentally flawed, the previous, more meaningful, practice-based survey was scrapped and this new survey brought in, with the results having devastating effects on some practices.'

The Department of Health will issue a ‘to do' guide for practices to improve patient access to practices later this week, and Mr O'Brien encouraged GPs to look at areas for improvement, such advance booking of appointments.

‘I think we have done very well on [access], but there will still be a need for some GPs to be aware that patients getting an appointment at a convenient time for them is important to them,' he said.

Brick wall: Minister has defended survey despite questions over sample sizes Brick wall: Minister has defended survey despite questions over sample sizes

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