scholarly journals Contract and ownership type of general practices and patient experience in England: multilevel analysis of a national cross-sectional survey

2017 ◽  
Vol 110 (11) ◽  
pp. 440-451 ◽  
Author(s):  
Thomas E Cowling ◽  
Anthony A Laverty ◽  
Matthew J Harris ◽  
Hilary C Watt ◽  
Felix Greaves ◽  
...  
Keyword(s):  
General Practice ◽  
Patient Experience ◽  
Linear Regression Analysis ◽  
Patient Survey ◽  
Medical Services ◽  
Cross Sectional Survey ◽  
Ownership Type ◽  
Cross Sectional ◽  
Patient Reports ◽  
General Practices

Objective To examine associations between the contract and ownership type of general practices and patient experience in England. Design Multilevel linear regression analysis of a national cross-sectional patient survey (General Practice Patient Survey). Setting All general practices in England in 2013–2014 ( n = 8017). Participants 903,357 survey respondents aged 18 years or over and registered with a general practice for six months or more (34.3% of 2,631,209 questionnaires sent). Main outcome measures Patient reports of experience across five measures: frequency of consulting a preferred doctor; ability to get a convenient appointment; rating of doctor communication skills; ease of contacting the practice by telephone; and overall experience (measured on four- or five-level interval scales from 0 to 100). Models adjusted for demographic and socioeconomic characteristics of respondents and general practice populations and a random intercept for each general practice. Results Most practices had a centrally negotiated contract with the UK government (‘General Medical Services’ 54.6%; 4337/7949). Few practices were limited companies with locally negotiated ‘Alternative Provider Medical Services’ contracts (1.2%; 98/7949); these practices provided worse overall experiences than General Medical Services practices (adjusted mean difference −3.04, 95% CI −4.15 to −1.94). Associations were consistent in direction across outcomes and largest in magnitude for frequency of consulting a preferred doctor (−12.78, 95% CI −15.17 to −10.39). Results were similar for practices owned by large organisations (defined as having ≥20 practices) which were uncommon (2.2%; 176/7949). Conclusions Patients registered to general practices owned by limited companies, including large organisations, reported worse experiences of their care than other patients in 2013–2014.

scholarly journals Importance of accessibility and opening hours to overall patient experience of general practice: analysis of repeated cross-sectional data from a national patient survey

2018 ◽  
Vol 68 (672) ◽  
pp. e469-e477 ◽  
Author(s):  
Thomas E Cowling ◽  
Azeem Majeed ◽  
Matthew J Harris
Keyword(s):  
General Practice ◽  
Patient Experience ◽  
Patient Survey ◽  
Cross Sectional ◽  
National Patient ◽  
General Practices ◽  
The Uk ◽  
Multilevel Linear Regression ◽  
Practice Patient

BackgroundThe UK government aims to improve the accessibility of general practices in England, particularly by extending opening hours in the evenings and at weekends. It is unclear how important these factors are to patients’ overall experiences of general practice.AimTo examine associations between overall experience of general practice and patient experience of making appointments and satisfaction with opening hours.Design and settingAnalysis of repeated cross-sectional data from the General Practice Patient Surveys conducted from 2011–2012 until 2013–2014. These covered 8289 general practice surgeries in England.MethodData from a national survey conducted three times over consecutive years were analysed. The outcome measure was overall experience, rated on a five-level interval scale. Associations were estimated as standardised regression coefficients, adjusted for responder characteristics and clustering within practices using multilevel linear regression.ResultsIn total, there were 2 912 535 responders from all practices in England (n = 8289). Experience of making appointments (β 0.24, 95% confidence interval [CI] = 0.24 to 0.25) and satisfaction with opening hours (β 0.15, 95% CI = 0.15 to 0.16) were modestly associated with overall experience. Overall experience was most strongly associated with GP interpersonal quality of care (β 0.34, 95% CI = 0.34 to 0.35) and receptionist helpfulness was positively associated with overall experience (β 0.16, 95% CI = 0.16 to 0.17). Other patient experience measures had minimal associations (β≤0.06). Models explained ≥90% of variation in overall experience between practices.ConclusionPatient experience of making appointments and satisfaction with opening hours were only modestly associated with overall experience. Policymakers in England should not assume that recent policies to improve access will result in large improvements in patients’ overall experience of general practice.

Prevalence and Benefits of Care Plans and Care Planning for People with Long-Term Conditions in England

2012 ◽  
Vol 17 (1_suppl) ◽  
pp. 64-71 ◽  
Author(s):  
Jenni Burt ◽  
Martin Roland ◽  
Charlotte Paddison ◽  
David Reeves ◽  
John Campbell ◽  
...  
Keyword(s):  
Patient Survey ◽  
Care Plan ◽  
Care Planning ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Long Term Conditions ◽  
Patient Reports ◽  
Care Plans ◽  
Interpersonal Care

Objectives Among patients with long-term conditions, to determine the prevalence and benefits of care planning discussions and of care plans. Methods Data from the 2009/10 General Practice Patient Survey, a cross sectional survey of 5.5 million patients in England. Outcomes were patient reports of: care planning discussions; perceived benefit from care planning discussions and resultant care plans. Patient and practice variables were included in multilevel logistic regression to investigate predictors of each outcome. Results Half the respondents (49%) reported a long-term condition and were eligible to answer the care planning questions. Of these, 84% reported having a care planning discussion during the last 12 months and most reported some benefit. Only 12% who reported a care planning discussion also reported being told they had a care plan. Patients who reported having a care plan were more likely to report benefits from care planning discussions. Several factors predicted the reporting of care planning and care plans of which the most important was patients' reports of the quality of interpersonal care. Conclusions There is a gap between policy and current practice which might reflect uncertainty as to the benefits of care plans. There is, therefore, a need for rigorous evaluation of care plans.

scholarly journals Couple relationship problems—a task for the general practitioner? A cross-sectional survey from Norway

2020 ◽  
Author(s):  
Siri Dalsmo Berge ◽  
Eivind Meland ◽  
Mette Brekke ◽  
Gunnar Tschudi Bondevik ◽  
Frode Thuen ◽  
...  
Keyword(s):  
General Practice ◽  
General Practitioner ◽  
Regression Models ◽  
Good Health ◽  
Couple Relationship ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Relationship Problems ◽  
Logistic Regression Models ◽  
General Practices

Abstract Background A healthy couple relationship is a predictor of good health. There is a lack of knowledge about what role family and couples counselling should have in general practice. Objectives To identify the prevalence of patients who have talked, or want to talk, with their general practitioner (GP) about their couple relationship, to investigate what characterizes these patients and to explore whether they believe that couple relationship problems should be dealt with in general practice. Methods We conducted a cross-sectional survey in 70 general practices in Norway during spring 2019. A questionnaire was answered by 2178 consecutive patients (response rate 75%) in GP waiting rooms. Data were examined using frequencies and linear and logistic regression models. Results We included 2097 responses. Mean age was 49.0 years and 61.3% were women. One in four (25.0%) had already talked with their GP about couple relationship problems, while one in three (33.5%) wanted to talk with their GP about their couple relationship problems. These patients more frequently had experience of divorce, poor self-rated health, an opinion that their couple relationship had a significant impact on their health and lower couple relationship quality when adjusted for age, sex, present marital status and children living at home. We found that 46.4% of patients believed that GPs should be interested in their couple relationship problems. Conclusion Relationship problems are frequently addressed in general practice. GPs should be prepared to discuss this issue to facilitate help for couples earlier than they might otherwise expect.

scholarly journals Parents’ and guardians’ views and experiences of accessing routine childhood vaccinations during the coronavirus (COVID-19) pandemic: A mixed methods study in England

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244049
Author(s):  
Sadie Bell ◽  
Richard Clarke ◽  
Pauline Paterson ◽  
Sandra Mounier-Jack
Keyword(s):  
General Practice ◽  
Mixed Methods ◽  
Childhood Vaccination ◽  
Vaccine Preventable Disease ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Preventable Disease ◽  
Telephone Interviews ◽  
Routine Childhood ◽  
General Practices

Objective To explore parents’ and guardians’ views and experiences of accessing National Health Service (NHS) general practices for routine childhood vaccinations during the coronavirus (COVID-19) pandemic in England. Design Mixed methods approach involving an online cross-sectional survey (conducted between 19th April and 11th May 2020) and semi-structured telephone interviews (conducted between 27th April and 27th May 2020). Participants 1252 parents and guardians (aged 16+ years) who reported living in England with a child aged 18 months or under completed the survey. Nineteen survey respondents took part in follow-up interviews. Results The majority of survey respondents (85.7%) considered it important for their children to receive routine vaccinations on schedule during the COVID-19 pandemic; however, several barriers to vaccination were identified. These included a lack of clarity around whether vaccination services were operating as usual, particularly amongst respondents from lower income households and those self-reporting as Black, Asian, Chinese, Mixed or Other ethnicity; difficulties in organising vaccination appointments; and fears around contracting COVID-19 while attending general practice. Concerns about catching COVID-19 while accessing general practice were weighed against concerns about children acquiring a vaccine-preventable disease if they did not receive scheduled routine childhood vaccinations. Many parents and guardians felt their child’s risk of acquiring a vaccine-preventable disease was low as the implementation of stringent physical distancing measures (from March 23rd 2020) meant they were not mixing with others. Conclusion To promote routine childhood vaccination uptake during the current COVID-19 outbreak, further waves of COVID-19 infection, and future pandemics, prompt and sustained national and general practice level communication is needed to raise awareness of vaccination service continuation and the importance of timely vaccination, and invitation-reminder systems for vaccination need to be maintained. To allay concerns about the safety of accessing general practice, practices should communicate the measures being implemented to prevent COVID-19 transmission.

scholarly journals General practitioners’ experiences with, views of, and attitudes towards, general practice-based pharmacists: a cross-sectional survey

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Ameerah S. Hasan Ibrahim ◽  
Heather E. Barry ◽  
Carmel M. Hughes
Keyword(s):  
General Practice ◽  
General Practitioners ◽  
Positive Impact ◽  
Clinical Skills ◽  
Community Pharmacists ◽  
Free Text ◽  
Full Time ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
General Practices

Abstract Background There is limited United Kingdom (UK) literature on general practice-based pharmacists’ (PBPs’) role evolution and few studies have explored general practitioners’ (GPs’) experiences on pharmacist integration into general practice. Therefore, this study aimed to investigate GPs’ experiences with, views of, and attitudes towards PBPs in Northern Ireland (NI). Methods A paper-based self-administered questionnaire comprising four sections was mailed in 2019 to 329 general practices across NI and was completed by one GP in every practice who had most contact with the PBP. Descriptive analyses were used and responses to open-ended questions were analysed thematically. Results The response rate was 61.7% (203/329). There was at least one PBP per general practice. All GPs had face-to-face meetings with PBPs, with three-quarters (78.7%, n = 159) meeting with the PBP more than once a week. Approximately two-thirds of GPs (62.4%, n = 126) reported that PBPs were qualified as independent prescribers, and 76.2% of these (n = 96/126) indicated that prescribers were currently prescribing for patients. The majority of GPs reported that PBPs always/very often had the required clinical skills (83.6%, n = 162) and knowledge (87.0%, n = 167) to provide safe and effective care for patients. However, 31.1% (n = 61) stated that PBPs only sometimes had the confidence to make clinical decisions. The majority of GPs (> 85%) displayed largely positive attitudes towards collaboration with PBPs. Most GPs agreed/strongly agreed that PBPs will have a positive impact on patient outcomes (95.0%, n = 192) and can provide a better link between general practices and community pharmacists (96.1%, n = 194). However, 24.8% of GPs (n = 50) were unclear if the PBP role moved community pharmacists to the periphery of the primary care team. An evaluation of the free-text comments indicated that GPs were in favour of more PBP sessions and full-time posts. Conclusion Most GPs had positive views of, and attitudes towards, PBPs. The findings may have implications for future developments in order to extend integration of PBPs within general practice, including the enhancement of training in clinical skills and decision-making. Exploring PBPs’, community pharmacists’ and patients’ views of this role in general practice is required to corroborate study findings.

scholarly journals Associations between diagnostic activity and measures of patient experience in primary care: a cross-sectional ecological study of English general practices

2017 ◽  
Vol 68 (666) ◽  
pp. e9-e17 ◽  
Author(s):  
Georgios Lyratzopoulos ◽  
Silvia C Mendonca ◽  
Carolynn Gildea ◽  
Sean McPhail ◽  
Michael D Peake ◽  
...  
Keyword(s):  
Communication Skills ◽  
Patient Experience ◽  
Patient Survey ◽  
Population Characteristics ◽  
Cross Sectional ◽  
Patients With Cancer ◽  
Urgent Referral ◽  
Relational Continuity ◽  
General Practices ◽  
Doctor Communication

BackgroundLower use of endoscopies and urgent referrals for suspected cancer has been linked to poorer outcomes for patients with cancer; it is important to examine potential predictors of variable use.AimTo examine the associations between general practice measures of patient experience and practice use of endoscopies or urgent referrals for suspected cancer.Design and settingCross-sectional ecological analysis in English general practices.MethodData were taken from the GP Patient Survey and the Cancer Services Public Health Profiles. After adjustment for practice population characteristics, practice-level associations were examined between the use of endoscopy and urgent referrals for suspected cancer, and the ability to book an appointment (used as proxy for ease of access), the ability to see a preferred doctor (used as proxy for relational continuity), and doctor/nurse communication skills.ResultsTaking into account practice scores for the ability to book an appointment, practices rated higher for the proxy measure of relational continuity used urgent referrals and endoscopies less often (for example, 30% lower urgent referral and 15% lower gastroscopy rates between practices in the 90th/10th centiles, respectively). In contrast, practices rated higher for doctor communication skills used urgent referrals and endoscopies more often (for example, 26% higher urgent referral and 17% higher gastroscopy rates between practices in the 90th/10th centiles, respectively). Patients with cancer in practices that were rated higher for doctor communication skills were less likely to be diagnosed as emergencies (1.7% lower between practices in the 90th than in the 10th centile).ConclusionPractices where patients rated doctor communication highly were more likely to investigate and refer patients urgently but, in contrast, practices where patients could see their preferred doctor more readily were less likely to do so. This article discusses the possible implications of these findings for clinical practice.

scholarly journals Patient-reported depression treatment and future treatment preferences: an observational study in general practice

2019 ◽  
Vol 36 (6) ◽  
pp. 771-777 ◽  
Author(s):  
Øystein Hetlevik ◽  
Gina Garre-Fivelsdal ◽  
Bjørn Bjorvatn ◽  
Stefan Hjørleifsson ◽  
Sabine Ruths
Keyword(s):  
General Practice ◽  
Treatment Preferences ◽  
Depression Treatment ◽  
Depression Care ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Future Treatment ◽  
Patient Reported ◽  
Study Population ◽  
General Practices

Abstract Background Depression is prevalent in general practice, but few studies have explored patient-reported depression care. Aim To investigate patient-reported treatment received for depression and future treatment preferences among adult patients visiting their GP, and to evaluate the associations with sex, age and educational level. Design and Setting A cross-sectional survey was conducted in general practices in Norway from 2016 to 2017. Methods Altogether, 2335 consecutive patients (response rate, 89.2%) in the GPs’ waiting rooms answered a questionnaire about their received depression treatment and treatment preferences in case of future depression. Results The study population (N = 2239) had a mean age of 48.6 ± 17.7 years (range 18–91), 60.1% were women. Of the 770 patients reporting to have received depression treatment, 39.1% were treated exclusively by their GP while 52.5% also were referred to a psychologist/psychiatrist. Older age was positively associated with medication and negatively associated with referrals to psychologist/psychiatrist. People with high education had lower odds for receiving medication (odds ratios [OR], 0.49; 95% confidence intervals [CI]: 0.30–0.80) compared to those with low education. If future depression, 81.6% of the respondents would discuss this with their GP, 60.9% would prefer talking therapy with their GP, 22.5% medication, and 52.9% referral to psychologist or psychiatrist. Conclusion One-third of the patients attending their GPs had consulted with them at some time concerning depression the case of future depression, most patients preferred talking therapy with the GP. This finding warrants increased research focus on the GP’s role in depression care.

scholarly journals A cross-sectional survey of the pharmacy workforce in general practice in Scotland

2019 ◽  
Author(s):  
Derek Stewart ◽  
Katie Maclure ◽  
Rosemary Newham ◽  
Kathrine Gibson-Smith ◽  
Rachel Bruce ◽  
...  
Keyword(s):  
General Practice ◽  
Complex Interventions ◽  
Workforce Planning ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Pharmacy Workforce ◽  
General Practices ◽  
Pharmacy Technicians ◽  
Strongly Agree ◽  
And Training

Abstract Background In Scotland, there has been significant investment in pharmacy teams in general medical practices over recent years, aligned to current government policy. Objectives To characterize the national pharmacy workforce including activities undertaken, perceived competence and confidence, as well as perception of integration of the intervention. Methods A cross-sectional survey of all pharmacists and pharmacy technicians in general practices. Survey items were demographics, activities undertaken and experiences. The NoMAD tool (Improving the Normalization of Complex Interventions) was included as a measure of perspectives of implementation. Post-piloting, a questionnaire link was sent to all pharmacists (n = 471) and pharmacy technicians (n = 112). A total NoMAD score was obtained by assigning 1 (strongly disagree) to 5 (strongly agree) to each item. Results Responses were received from 393 (83.4%) pharmacists and 101 (91.8%) pharmacy technicians. Three quarters of pharmacists (74.6%) and pharmacy technicians (73.3%) had been qualified for over 10 years. Two-thirds of pharmacists (68.4%) were independent prescribers, with three quarters (72.3%) currently prescribing. Respondents worked in a median of two practices and were providing a range of activities including medication/polypharmacy reviews, medicines reconciliation, prescribing efficiencies and training. Respondents reported high levels of competence and confidence (median 8, scale 0–10 highest). Median NoMAD total score (scale 20–100 highest, Cronbach’s alpha 0.89) was 80 for pharmacists and 75 for pharmacy technicians, P ≤ 0.001. Conclusions The general practice pharmacy workforce in Scotland is experienced, well-qualified and integrated within general practices, delivering a range of activities. These findings have implications for workforce planning and future education and training.

scholarly journals Online and telephone access to general practice: a cross sectional patient survey

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2020.0179
Author(s):  
Carol Bryce ◽  
Matthew DL. O'Connell ◽  
Jeremy Dale ◽  
Martin Underwood ◽  
Helen Atherton
Keyword(s):  
General Practice ◽  
Patient Characteristics ◽  
Patient Survey ◽  
Remote Access ◽  
Online Information ◽  
Online Services ◽  
Cross Sectional ◽  
Face To Face ◽  
The United Kingdom ◽  
General Practices

BackgroundImproving access to primary healthcare in the United Kingdom has focused on the use of telephone and online access but little is known about how awareness of and use varies between different patient groups.AimTo determine how patients are interacting with telephone and online channels for accessing general practice services and information, and to analyse how this varies according to patient characteristics and health status.Design & settingA cross sectional self-administered survey of adult patients in general practices across the West Midlands, UK.MethodDescriptive statistics were used to show participants’ awareness of and interaction with online information sources and remote access. Multivariable logistic regression was used to model the relationships between demographic and health characteristics and awareness and use of online services and alternatives to face to face consultations (e.g. telephone).Results2789 patients (response rate 19.0%) from 43 general practices participated. 60.8% (1651/2715) of participants were aware of online services and 30.3% (811/2674) reported having used one. Daily internet usage and frequently visiting the GP showed the strongest associations with knowledge and use of online services.ConclusionWe have shown that there is the potential for inequitable awareness and use of telephone and online services in general practice populations. Given that their use has greatly increased due to the COVID-19 pandemic future service design will need to ensure this is taken into account.

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