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Results Published Of The National Survey Of Nhs Patients 1998

  • Published date:
    12 April 1999

Statistical Press Release

The first annual National Survey of NHS Patients in England was administered as a self-completion questionnaire sent by post to 100,000 people selected at random from the Electoral Registers. It was carried out between October and December 1998.

The survey focused on patients' experience of NHS General Practice. The survey covered a wide range of issues including, access, communications, patients' views of GPs and practice nurses, quality and range of services including out-of hours care, and referrals by GPs to hospital.

The main findings are:

  • Over 80% of respondents had seen their GP in the last year. Of these people, most had found services to be satisfactory, though people aged under 45 tend to be less satisfied. Most patients consider that GPs take their opinions seriously, are understandable, and the majority felt well informed about their condition or treatment. 80% consider their NHS GP knows what treatment is best and 90% consider that the GP made, in their opinion, the right diagnosis most, if not all of the time.
  • Nearly all of the 50% of patients who saw a practice nurse felt that the nurse knew enough about their condition; and the large majority felt the nurse answered their questions, and took appropriate action to help them.
  • As regards access to their NHS GP, 4 out of 5 patients thought their appointment with their GP was as soon as necessary, although19% of patients considered their appointment with their GP should have been sooner and 25% of appointments necessitated a wait of 4 or more days. More than 1 in 3 of people referred to hospital by their GP considered their condition got worse while they were waiting to be seen.

In more detail the findings are:

CONTACT WITH GP

  • More than 4 in 5 adults (81%) had visited their GP in the preceding 12 months. The proportion was somewhat higher for women than for men and, among men, for older persons. However even among men aged under 45, the proportion does not drop below 70%.
  • Of those adults who had visited their GP in the last 12 months, 32% had visited in the preceding month. (This means that just over 1 in 4 of all adults had visited their GP in the last preceding month.) A higher proportion of women than men had seen their GP in the last month.
  • 4 out of 5 patients thought their appointment with their GP was as soon as necessary, although 19% of patients considered that their appointment should have been sooner than it was. Younger men and women tended to be more critical in this respect than older people; among those over 65, 9 out of 10 said their appointment was as soon as necessary. A quarter of patients said they usually had to wait 4 or more days for an appointment.
  • Once at the GP's surgery 3 in 5 adults were seen within 15 minutes and 87% were seen in less than half an hour, leaving13% who had to wait half an hour or more. These proportions were broadly the same across all age groups.
  • Overall, just over half of all patients spent between 5 and 10 minutes with their GP; 1 in 4 patients spent fewer than 5 minutes; a similar proportion spent 10 minutes or more, generally under 20 minutes. The time spent with the GP was the same both for men and women, but varied according to the age of the patient; the younger the patient the less time spent. 87% of patients said that their GP spent the right amount of time with them, leaving a little over one in 10 men and women who considered that their GP should have spent more time with them on the occasion of their last visit. Among persons aged under 35the proportion saying their GP should have spent more time varied between 16% and 20%.
  • Overall, during the preceding 12 months, 15% of patients had put off a visit to their GP because of the inconvenience of the surgery hours. Among patients under the age of 45, this proportion was somewhat higher (1 in 4 among women). Nearly 40% of adults said that when they telephoned their GP surgery, only on some occasions did they get through at the first attempt. A substantial proportion of this group said that they never or hardly ever get through first time. This criticism was particularly likely to be made by persons of working age, ie under 65.
  • Of patients who had visited their GP in the preceding 12 months, four-fifths said that the receptionist had never 'made it difficult' to see or talk to their GP, and the remaining 1 in 5 had experienced difficulty at least once. Among those aged 65 or over, fewer than 1 in 10 patients said they had had difficulties in this respect.

COMMUNICATION WITH GP

  • More than 2 in 5 patients considered that they were not always given enough information about their condition or treatment. Women were somewhat more likely to take this view; young persons also were more critical of the amount of information given by their GPs.
  • Very few patients reported difficulty in understanding their GP. 19 out of 20 said that (s)he was very or fairly easy to understand.
  • 8 out of 10 patients considered that their GP 'took their opinions seriously' and the same proportion that the GP 'listens to them no matter how busy (s)he is'. Younger people were less likely to hold this view.

VIEWS OF GP AND SURGERY

  • Nearly half of patients overall, but only around one third of men and women under the age of 45, considered that the GP knew 'a lot' about their medical history.
  • Nonetheless, on the occasion of the last visit, 84% of patients considered that the GP was sufficiently well-informed about their condition or treatment. A similar proportion considered that the GP took appropriate action on that occasion.
  • One in 8 patients had considered making a complaint about the GP, or someone at the surgery. In very few cases, however, did respondents say that a complaint actually was made. Women, and in particular younger women, were more likely than men to have considered making a complaint. Where a complaint was made it was likely to have related to the GP him/herself or the receptionist, not to the practice nurse or other members of staff.
  • 80% of patients considered that their GP knew 'the treatment that is best'. 90% considered that their GP made the 'right diagnosis' most, if not all the time.
  • Among those under 45, two-thirds of women and one-third of men considered it important to see a GP of their own sex.

PRACTICE NURSES

  • 1 in 2 patients had seen the nurse on their own behalf, with some variation by age and sex. Patients over 65 and women patients were more likely to have visited a nurse. Fewer than one third of men aged under 45 had seen a nurse.
  • 90% of patients felt that the nurse knew enough about their condition or treatment.
  • Fewer than 1% of patients reported that nurses did not answer any of their questions and only 1% felt that the nurse did not take appropriate action to deal with the reason for the visit.
  • Virtually all (96%) patients said the nurse explained the reasons for the action taken clearly, with only 4% reporting that the nurse was difficult to understand or that the nurse did not explain the reasons at all.
  • Only 1% of patients reported that the nurse did not treat them with courtesy and respect.

OUT-OF-HOURS CARE

  • 14% of the population had telephoned the GP surgery out-of-hours. Among women under 35, the proportion was nearer to 1 in 5.
  • The call resulted in a home visit by the patient's own GP for 1 in 5 patients, and by another GP for 1 in 4 patients. A further one fifth of patients were given advice over the phone. Other patients were advised to call another number (8%), visit the surgery when open (16%), visit an out-of-hours surgery (14%) or go to a hospital Accident and Emergency unit (14%). (Many patients gave more than 1 answer to this question.) Three quarters of patients over 65 received a visit at home from a GP and relatively fewer people over 65 (4% of men and 3% of women) were asked to attend an out-of-hours surgery.
  • The doctor was considered to know enough about their condition or treatment by about three quarters of patients.
  • 80% of patients felt that the GP took appropriate action to deal with the reason for the visit and only 6% felt that the action was not appropriate. 90% of patients said it was easy to understand the explanation for the doctor's action, while 10% reported that they had difficulty understanding the explanation or that the action was not explained at all.

HOSPITAL REFERRALS

  • Over 1 in 3 patients had been referred by their GP to a specialist or hospital doctor, with people over 65 being more likely to be referred. Only 2% of patients felt that they should have been referred in the last 12 months but were not. 80% of patients felt that the reason for their referral had been very clearly explained
  • Overall 88% of patients thought they were referred at the right time, and 12% considered that their referral was too late. Among those aged under 45, the proportion who felt the referral was late was somewhat higher than among older people. Fewer than 1 in 5 were able to choose the hospital of referral. 7% of all patients felt that they should have been allowed a choice but were not offered it.
  • Around one in ten of patients were seen by a specialist on the same day as they were referred by their GP. About 50% of those referred to a specialist/hospital doctor had to wait over a month for the appointment; 20% had to wait over 3 months. More than 1 in 3 of those waiting for an appointment with a specialist considered that their conditions got worse while they were waiting to be seen. 14% claimed to be in a lot of pain during the waiting period. More than half considered that their condition during the waiting period limited their work and daily activities. Of men of working age (under 65) half considered they should have been seen sooner than they were.

Notes for Editors

  1. A 20 page postal questionnaire was sent in October 1998 to 100,000 adults selected at random from the Electoral Registers. A response rate of 64.5 % was achieved after discounting ineligible addresses. The results are based on 61,426 completed questionnaires. 81 % (c50,000) of respondents had seen a GP in the last 12 months.
  2. The survey was carried out by a consortium of Social & Community Planning Research (SCPR), an independent research organisation together with Picker Europe and the Imperial College School of Medicine.
  3. Copies of the tables underlying the commentary in this Press Notice are available from Duncan Innes, NHS Executive, Room 3E45, Quarry House, Quarry Hill, Leeds, telephone no. 0113 2546107, and other analyses will be available on request. More detailed tables presenting the results by age, sex, social class and economic activity will be included in a report to be published in the summer and will be made available on the Internet.
  4. Results at Health Authority level and a full report including analyses by social class, ethnic group and region will be published in the Summer.
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