Patients’ experience of primary care: James Mackenzie Lecture 2017

INTERNATIONAL CONTEXT

An increased supply of primary care doctors who are demonstrably valued within their health economy is associated with lower average population mortality, a range of beneficial health outcomes, and with better patient experience of care.¹ The delivery of high-quality patient experience of care is one of three central aims of healthcare systems, and the Commonwealth Fund has recently highlighted the strong position of UK health care in respect of access to care for the population.² The first National Patient Survey (1998) was inaugurated after NHS proposals suggested that patients’ views on quality of care should be taken into account, and the Constitution of the NHS has enshrined the importance of the experience of patients within UK health care.³

MONITORING PATIENT EXPERIENCE

The US-derived Primary Care Assessment Survey⁴ informed the development of GPAQ, the UK’s General Practice Assessment Questionnaire.⁵ From 2006, practices could benefit financially under the UK Quality and Outcomes Framework — around £6000 for an average practice — provided they had developed a written plan around access, had conducted a patient experience survey using an approved instrument (such as GPAQ), and had consecutively surveyed patients attending their practice.

By 2007, the National GP Patient Survey (GPPS) focused on issues relating to appointment availability, routine appointments, telephone access, and continuity of care. Emerging research evidence around the development and use of the survey⁶ provided some confidence to politicians and healthcare planners regarding its potential. Between 2009 and 2011, it was used to reward practices under a ‘pay-for-performance’ scheme. The GPPS continues to inform national policy …