Satisfying the patient in primary care: a postal survey following a recent consultation

Abstract

Background: Factors over and above the skills of the health care professional appear to impact on how well patients can cope with an illness following a consultation in general practice. These other factors appear to relate to the organisation and fabric of the doctor's practice. This study reports a systematic analysis of responses to a questionnaire survey of patients following a telephone consultation in a general practice setting. This study aims to explore how views on specific aspects of a general practice service contrast among patients. Methods: A structured anonymised postal questionnaire was sent to 916 patients within 24h of a telephone consultation with a doctor or nurse in five general practices in North Trent, UK. No reminders were sent. Included on the questionnaire were free-text questions that invited opinions on areas for improvement for the patients' registered practice. These were analysed qualitatively using content analysis by two independent researchers.Results: The overall response rate was 52% although responses from young men were under-represented in the survey. One in three responders expressed a need for improvements in the practice. Five themes and a number of sub-themes were identified. Patients wanted more appointments, more access and less delay before appointments. Other themes included a desire for better communication, more patient friendly policies and facilities. Analysis suggests that it would be very difficult to satisfy the contrasting and divergent needs of all patients. Conclusions: Communication with patients in general practice is influenced by the fabric, policies and reception staff in the practice as much as by the skills and resources of the care provider. Seeking patients' opinions about the practice within the context of a recent telephone consultation unearthed conflicting desires that cannot be satisfied given existing resources in the National Health Service (NHS). Patients favour a speedy, convenient and above all, tailored service. This may be impossible to deliver universally. Attention to the non-doctor aspects of the service may enhance the ability of practitioners to enable patients to cope with illness. The data suggest that patients are not universally satisfied with the service provided and that it would be naive to attempt to please them all.