Patient satisfaction: Pressure on GPs is filtering through to the public

General practice has higher patient satisfaction ratings than any other NHS service, says King's Fund fellow Ruth Robertson. But soaring demand, a recruitment crisis and tight NHS finances have seen satisfaction on the slide, and the profession faces a struggle to keep patients happy.

Each year we get invaluable insight into how the general public rate the NHS through the Natcen Social Research’s British Social Attitudes (BSA) survey. The survey has been tracking public satisfaction with the NHS since the 1980s and for the past five years, The King’s Fund has been commissioning the NHS satisfaction questions. These have traditionally been seen as a key indicator of what the public thinks about the NHS.

The latest data shows that NHS satisfaction dropped by 5 percentage points in 2015 to 60%. At the same time, dissatisfaction rose by 8 percentage points, meaning almost one in four members of the British public (23%) are dissatisfied with the health service.

What lies behind these ratings? When we asked people why they were satisfied or dissatisfied with the NHS it became clear that their ratings reflect a range of factors including their views on politics, policy and public institutions as well as their experience using the NHS. The quality of NHS care was a major reason people were satisfied with the NHS, but so was the range of services available and the fact the NHS is free at the point of need.

Read more: GPs top NHS satisfaction ratings

It seems that when saying they are satisfied with the health service overall, many are signalling a vote of support for the NHS as an institution, not just simply commenting on their experience of it. Unsurprisingly, waiting times were a major reason given for dissatisfaction, along with staff shortages and a lack of funding for the health service.

Do GPs fare any better? The BSA also asks the public for their opinion of five different NHS services: inpatient, outpatient, accident and emergency, dentistry and GP services. Every year, GP services get higher satisfaction ratings than any other part of the NHS. This is in line with other polling that shows doctors are the most trusted profession (more so than - among others - teachers, scientists, the clergy and the police, according to MORI).

Despite this, GP satisfaction of 69% in 2015 is the lowest rate recorded in the BSA’s history. Satisfaction has been declining steadily for the past five years and in 2015 is 10 percentage points lower than it was in 2009.

GP satisfaction

Why is satisfaction with GP services declining? It’s important to remember that this is a survey of the public and not patients, not all respondents will have visited their GP in the past year. But perhaps more than any other service, public views on general practice are likely to be influenced by actual experience - people visit their GP on average six times a year.

The finding that GP satisfaction is declining is backed up by the national GP patient survey (although the trend is less pronounced): while 88% of patients rated their overall experience as good in that survey in 2012, the figure was down slightly to 85% in 2016.

Media stories are also likely to have played an important part in the public’s ratings of GP services. Our media analysis for the period that this survey was in the field (July to October 2015) found that reports about the problems patients have getting a timely GP appointment was one of the top health stories. Problems recruiting GPs and stress levels among the profession have also been widely reported.

Whether through the media, the stories people hear from family and friends, or their actual experience of GP services - the well-publicised pressures in general practice are filtering through to the public and starting to show up in surveys of their views of general practice.

Over the next year, as the financial pressures in the NHS intensify and patient demand remains unabated, it will remain to be seen whether GP services can hold on to their crown as the most highly rated NHS service by the public.

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