A new Which? investigation, using undercover fieldwork and surveys of both patients and GPs, found wide differences in the quality of consultations, a reluctance of patients to complain and GPs not acting on patient feedback.
As part of this new investigation, we sent trained undercover fieldworkers into 30 GP practices across the country to assess the consultations given to patients. We found wide differences in the quality and length of consultation and the diagnosis despite GPs being presented with the same conditions.
Consultation times varied between three minutes to 20 minutes for the same patients with the same symptoms. Our expert panel, including three practising GPs, rated over a third of the visits as poor with 14 rated as good, and four satisfactory. We also found a link between the length of consultation and the rating, with all 12 ‘poor’ consultations lasting eight minutes or less and all but two of the 14 ‘good’ visits lasting 10 minutes or more.
Our separate survey of patients uncovered a widespread reluctance to complain. More than half (58%) of patients who said they had experienced a problem with a GP in the last 12 months told us that they did not complain. Of these, more than a quarter (27%) think it could lead to worse service or treatment and just over half (51%) believe that nothing would be done.
This was reflected in our survey of GPs which found half (50%) said they do not review the feedback given by their patients on the national patient survey and nearly half (47%) don’t publicise their complaints procedure. Two in five (40%) said they don’t change policies and procedures based on the feedback they receive.
From April, Local Healthwatch groups will provide a new channel for patient feedback and their role is to help shape local services, putting feedback at the heart of improving quality. Which? wants to see Local Healthwatch playing a strong and active role in influencing GP services, ensuring that the patient voice is heard.
Richard Lloyd, executive director at Which? said:
“GPs work hard to do their best for their patients, but it’s worrying that people with the same symptoms could have such different experiences when they go to the doctor. The Government is committed to making sure that the NHS is better at listening to what patients want, and our findings show that there is a lot to do. The changes taking place in the NHS, with a new regulator and patient groups being set up, are an opportunity to make sure that patients’ voices are being heard and acted on.”
Notes to Editors
1. Our undercover patients visited 30 GPs in practices across England in December 2012 (one GP per practice), using three scenarios: a woman at possible risk of a stroke because of her medication; a man wanting sleeping pills to cope with undiagnosed depression; and a woman with symptoms that could point to an underlying heart problem. Their hidden video and audio recordings were analysed by an expert panel compromised of three practising GPs with additional expertise including research and clinical commissioning, and a lay person with extensive strategic and research experience in primary care.
2. GP survey: We conducted a representative survey of 1001 UK GPs online between 22nd and 31st August 2012. Data were weighted to be demographically representative of all UK GPs.
3. UK public survey: We conducted a representative survey of 5257 UK adults online between 9th and13th July 2012. Data were weighted to be demographically representative of all UK adults.
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