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Patient satisfaction is higher at smaller practices



In January MORI published the results of its latest patient satisfaction survey. For Southend-on-Sea, a south Essex borough with a population of 178,000, and the town in which my small GP practice is situated, the figures make very interesting reading.

There seems to be a policy (unstated) at NHS England to squeeze out smaller practices

Satisfaction among Southend’s 34 practices ranged from 97% to 57%, and 12 practices had a rating below 85%. Of the 19 practices with a rating of 87% and above, 18 were small practices. The worst-rated practice, with just 57% satisfaction, was a large multi-partner practice. In other words, the survey reveals patient satisfaction to be greater among small than among large practices.

Unfortunately, there seems to be a policy (unstated) at NHS England to squeeze out smaller practices in favour of large practices despite the excellent quality of care they provide. In pursuance of this policy investment of scarce resources continues to be concentrated on innovation and large practices, to the detriment of small practices. But the Southend patient satisfaction ratings reveal the policy and funding inequalities to be misguided, and point to the need for a reassessment.

Perhaps the biggest threat to small practices is from the CQC which is extremely demoralising and seems to be weighted against small practices. This occurs at a considerable cost to the taxpayers as well as the provider service of the health system, and does not improve quality.

Secretary of State Jeremy Hunt has publicly declared his support for continuity of care and dedicated named GPs for all frail and elderly patients. It is surely a matter of regret that his views do not seem to be shared by top NHS managers, nor, it seems do they have the support of the BMA, GPC, LMC and RCGP.

I end with a plea for NHS England and the Department of Health to provide a structure that values and supports equally all patients irrespective of their age and treatment, whether it be in a large or small infrastructure.