GP services run by private firms 'worse for patients'

Patients at GP practices run by limited companies report worse experiences of care on average than their counterparts at other types of practices, researchers have found.

GP consultation (Photo: Robert Johns/UNP)
GP consultation (Photo: Robert Johns/UNP)

Data from the GP patient survey - which records patient satisfaction across a range of key indicators for practices across England - show generally positive experiences of primary care.

Patients consistently rate general practice highly despite the growing crisis facing the profession, with the 2016 survey finding that 85% of patients rate their overall experience of primary care as good.

But analysis of variations in patient satisfaction across different types of provider reveals that practices run by limited companies perform worse on four out of five key indicators - 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.

Research published in the Journal of the Royal Society of Medicine based on 2013/14 survey data from more than 8,000 GP practices compared mean satisfaction scores for practices run by limited companies with those run by other providers. It found that on overall experience, the mean score for practices operating on APMS contracts run by limited companies was 3.04 points lower on a 100-point scale than practices on GMS deals.

Map: where are APMS contracts most common?

For appointment convenience and doctor communication, the mean score fell short of that achieved by GMS practices by a similar amount, while on consulting a preferred doctor, they scored 12.78 points lower.

The researchers said: 'Our results suggest that [APMS] practices consistently provided a worse experience for patients only when owned by limited companies. We additionally found that practices owned by large organisations [20 practices or more] provided worse experiences on average than practices with a [GMS] contract, which are typically small general practitioner partnerships. Our findings highlight limited companies as providing worse experiences of primary care, rather than practices with the [APMS] contract collectively.'

Lead author of the research Dr Thomas Cowling said: 'Across all contract and ownership types, patients generally reported positive experiences of their general practices. However, patients registered to general practices owned by limited companies reported worse experience of their care than patients registered to other practices on average.'

He added: 'It is the responsibility of commissioners, regulators, clinicians and owners to guarantee that individual practices meet expected standards while ensuring that care quality is not systematically associated with the ownership.

'Commissioners also need to ensure that contracts offer good value for money, more so at a time when the NHS is very financially challenged.'

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