High QOF scores 'linked to happy patients'

Practices can boost QOF scores by keeping patients happy, a report by a leading think tank has found.

Dr Michelle Drage: London practices face tough challenges

A King's Fund study, Improving GP services in England, compared QOF and GP Patient Survey (GPPS) data for 2010/11 for all practices in England.

It found practices that scored highly in patient satisfaction surveys also achieved high clinical outcomes and QOF scores. Practices with more GPs were found to fare better on patient experience and QOF outcomes.

The study found a strong link between a practice’s QOF scores and patient experiences of using its services. ‘In particular, patients’ feedback on ease of access to their general practice consistently showed a strong link with the process and outcome indicators for all clinical conditions,' the report said.

'Patients’ responses to questions about the information they received also consistently showed a clear positive link with all process and outcome measures of quality of clinical care.’

The study suggested that patients' ease of access to their practice and preferred GP could affect quality of care and outcomes ‘through its impact on attendance rates, continuity of care, communication and engagement with clinical staff, compliance and adherence with treatment, and out-of-hours access’.

Co-author of the study and senior fellow at the King’s Fund, Veena Raleigh PhD, said the study had not established a causal link between QOF scores and patient satisfaction. But she said: ‘It is realistic to expect that enabling easier access, meeting patients’ preferences, involving them in decisions will improve compliance with treatment and better engagement in self-care in general.’

Practices that performed poorly both on patient experience and clinical quality tended to be in London or deprived areas. London practices fared worse than practices in other parts of England both on QOF and patient experience scores.

London practices scored particularly badly in the ‘dignity and respect’ domain of the patient survey. Londonwide LMCs chief executive Dr Michelle Drage said the results were not a reflection of the standard of GPs in London. ‘We know London is not typical of the rest of the country,’ she said.

Dr Drage said London GPs were campaigning for longer consultation times to help them cope with hugely diverse patient populations, and called for investment in premises and services.

Dr Raleigh said: ‘London practices face particular challenges, but we can see variation in performance even within London, and there are examples of innovative practices that are performing better despite these obstacles.

'This can be done, for example, by tailoring services to the specific needs of local populations. The challenge for those providing and commissioning services in London is to learn from these innovations so that they can transfer elsewhere.’

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