Professor Martin Roland, director of the National Primary Care Research and Development Centre in Manchester, and colleagues studied 42 practices in England.
The researchers sent questionnaires to patients in 2003, 2005 and 2007. There were no changes in quality of care in terms of communication, co-ordination and overall satisfaction. But patients said they found it harder to see their usual GP and were less satisfied with the continuity of the care they received. The researchers blame access targets.
'This outcome may be related to the incentives to provide rapid appointments or to the increased number of specialised clinics in primary care,' they said. 'Unintended effects need to be considered when introducing pay for performance schemes.'