Patient satisfaction with GP services has taken a 30 percentage-point dive since before the pandemic, according to new research.
GP leaders branded the news ‘devastating’, blaming long-term underfunding of general practice as the root cause behind the plummeting scores.
This was also supported by analysts, who said that while the situation was worsened by the pandemic, the squeeze on NHS funding and workforce was ‘decade-long’.
An analysis of responses to the British Social Attitudes Survey found the proportion of patients who were satisfied with GP services plummeted from 68% to 38% since 2019.
The survey of 3,112 people across England, Scotland and Wales was carried out by the National Centre for Social Research (NatCen) in September and October 2021.
And the new analysis, carried out by think-tanks the King’s Fund and the Nuffield Trust, found that:
- Fewer than four in 10 patients (38%) were satisfied with GP services.
- A higher proportion – 42% – were dissatisfied with GP services.
- Satisfaction with general practice is now lower than any other NHS service except dentistry.
The devastating findings come as general practice had been the highest-rated service every year up until 2018, when ratings dropped to a previous record low of 63%.
Overall, NHS satisfaction fell to 36%, with record falls across all individual services, and 41% of patients saying they were ‘dissatisfied’ with NHS services.
The report noted that general practice is the service used by the largest numbers of people, meaning patient dissatisfaction is ‘likely to have had a significant impact on overall satisfaction with the NHS’.
Waiting too long for a GP or hospital appointment was the most common reason given for dissatisfaction (65%), followed by staff shortages (46%) and Government funding (40%).
The report highlighted that the survey took place during ‘unprecedented changes in response to the pandemic’ such as a rise in remote consultations in general practice.
It continued: ‘Action to tackle waiting times for planned care is unlikely to be enough for public satisfaction with the NHS to recover.
‘Addressing pressures on general practice and improving access for patients will be key if satisfaction is to rise in future years.’
When asked what the most important priorities for the NHS should be, the top three cited by survey respondents were:
- Making it easier to get a GP appointment (48%);
- Improving waiting times for planned operations (47%); and
- Increasing NHS staff numbers (47%).
Dan Wellings, senior fellow at The King’s Fund said: ‘Our analysis reveals an unprecedented drop in public satisfaction with the NHS, which now stands at its lowest level in 25 years. People are often struggling to get the care they need and identified access to general practice, waiting times for hospital care and staff shortages as areas that need to improve.
‘These issues have been exacerbated by the extraordinary events of the past two years but have been many years in the making following a decade-long funding squeeze and a workforce crisis that has been left unaddressed for far too long.’
BMA council chair Dr Chaand Nagpaul said: ‘The truth is that the NHS in England has been underfunded for so long and we went into the pandemic frighteningly ill-prepared for what was to come. Now staff morale is at an all-time low with doctors leaving the NHS every day.
‘Commitments made by the UK Government, like the recruitment of more GPs, are routinely missed, while at the same time rejecting demands from the House of Lords and over 100 medical organisations for transparent workforce planning.’
He also urged the Government to ‘change course and invest in the workforce’, adding that the BMA was ‘bitterly disappointed’ the spring statement didn’t make ‘any in-roads into tackling the increased demand and pressure that the NHS is now facing’.
He said: ‘The starting point must be to openly acknowledge and tackle the infrastructure deficit in the NHS, beginning with long-term and transparent workforce planning that addresses the shortages and retains our highly skilled workforce through better remuneration, tailored wellbeing support and a change to the punitive pensions taxation rules with immediate effect.’
Dr Rachel Ward, a GP in Oxfordshire who is part of the Rebuild General Practice campaign, said: ‘As a doctor who came into general practice to look after patients, this data is devastating, but it isn’t surprising. Years of underfunding and neglect has left general practice in crisis.
‘Recruitment and retention of GPs has not kept up with growing demands, yet patient appointments are at an all-time high. Simply, there are not enough GPs to match patients’ needs – and this is the terrible result.
‘To patients, we want to say that we are on your side and we feel your pain. To Government, we ask again for more support to rebuild general practice so that GPs can provide the quality of care our patients deserve.’
RCGP chair Professor Martin Marshall said: ‘We are extremely disappointed and saddened by these findings, which reflect a service working under crippling staffing and resource pressures following the pandemic, which has pushed general practice, and the wider NHS, to its limits.’
Warning that general practice was already ‘stretched to its limits’ before the pandemic, he added: ‘GPs and patients want the same thing, and we share patients’ concerns about the difficulties they face in accessing GP appointments.
‘It is vital that today’s report is not used as another opportunity to denigrate and demoralise hardworking GP teams, but that these findings serve as a wake-up call to Government and policy makers on the need for urgent action to boost the GP workforce so that there are enough GPs and practice team members to deliver safe, timely and appropriate care to all patients.’
The British Social Attitudes survey randomly selects households to take part in the survey either online or over the phone. Respondents are asked whether they are ‘very satisfied’, ‘quite satisfied’, ‘quite unsatisfied’, ‘very unsatisfied’, neither or don’t know about a series of NHS services.
In contrast, the annual GP patient survey, which polled 850,000 patients in England in January and March 2021, found 83% had an overall ‘good’ experience of their GP practice this year and 82% were ‘satisfied with the appointment offered, and accepted it’.
General practice underfunding
The news comes as last week’s spring budget statement did not pledge any additional funding for general practice or the wider NHS.
The National Insurance rise is expected to raise billions for NHS and social care, however despite this, the Treasury has decided to double the NHS’ annual efficiency target from 1.1% to 2.2% a year – meaning purse strings will need to be tightened further.
The health secretary has also said there will be no additional funding for workforce expansion as part of the work to clear the NHS backlog.
The BMA had urged the Treasury to stump up a further £5-7bn in funding to clear the elective care backlog in England, 10% of which it said must go towards general practice.
The doctors’ union had also called for a drastic expansion in medical school places; increased pay for NHS doctors; a ‘solution’ to ‘punitive’ pension taxation which is prompting GPs to retire ahead of time; a £1bn ‘welfare and wellbeing fund’ for NHS staff; continued free Covid testing for NHS staff; and increased funding for mental health and public health.
In England, this year’s GP contract was imposed upon the profession, after NHS England declined to provide additional support requested by the BMA.
The BMA had asked for:
- resources to manage general practice pressures;
- a long-term-conditions recovery fund;
- reform of childhood immunisations IOS (Item of Service) and QOF (Quality and Outcomes Framework), with ‘additional support for childhood immunisations’ within QOF to enable practices to ‘deliver more for their patients without being financially penalised’;
- a tapered approach to QOF to support recovery;
- the provision of long Covid occupational health; and
- a new contract for general practice.
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