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GP relationship is most important factor in patient satisfaction, study finds



Communication with GPs is a far greater indication of patient satisfaction than Government priorities such as continuity of care and access to GP services, a major study has shown.

The study of data from the 2009/10 English General Practice Patient Survey, published in Health Expectations and involving more than two million respondents, showed that patient satisfaction is only very weakly linked to continuity of care, ease of phone access and whether appointments can be booked quickly.

The findings contrast sharply with the policy of the Government, which has made access to GP services a priority.

The researchers from the University of Cambridge said that their work highlighted the need for new doctors to be taught communication skills, and that revalidation may be a good means of identifying more experienced doctors who need help.

They calculated ‘standardised regression coefficients’ in the range 0-1 to indicate increasing strength of the link between each variable and patient satisfaction.  For doctor communication the figure was 0.48, compared with 0.22 for the helpfulness of reception staff, 0.11 for quick appointments and 0.09 for phone access. It was only 0.06 for obtaining appointments in advance.

The paper states: ‘Teaching new doctors how to communicate well with their patients is one part of improving physician communication. At least as important may be identifying existing doctors with poor communication skills and developing effective means to improve them.’

Dr John Grenville, a GP in Derby and secretary of Derbyshire LMCs, said: ‘The study finding is entirely predictable. If you look at patient complaints you find that the root cause of 95% is a failure of communication. At our LMC we think that consultations should be extended from 10 minutes to 15 or 20 – because if you have more time there is more chance that a doctor and a patient will communicate better.’

He added: ‘Perhaps appraisals could be the time to remind GPs about communication and ask what they are doing to make sure that it is good.’

Dr Peter Fink, a GP in South Manchester and an urgent care lead for South Manchester CCG, believes that for some patients access to appointments is of greater significance than is reflected in the research. ‘I don’t think you should apply these findings to every region. In Greater Manchester there are a lot of people from ethnic backgrounds or who are not working because of poor health – and access to GP services is very important to them.’

The research showed that although access was not strongly linked to satisfaction overall, it was more important for 18-25 year-olds than the over 75s. Professor Roland and the team acknowledged that their results contrasted with previous research showing that patients prioritised technical quality of care – such as a thorough physical examination – over interpersonal quality of care.

Health Expect 2013, available online 30 May: http://onlinelibrary.wiley.com/doi/10.1111/hex.12081/abstract