A significant proportion of surgeries have lost funding unfairly as a result of the GP Patient Survey, despite results that show most patients are happy with access to their GP, the British Medical Association (BMA) has said.
Responding to the publication of the results today (30 June 2009), Dr Laurence Buckman, Chairman of the BMA's GPs' Committee (GPC), said: "We are pleased that the vast majority of patients are satisfied with the service they receive, however the headline figures hide a gross unfairness – thousands of surgeries losing funding based on the answers of a tiny proportion of their practice's population.
"In some cases the answers of fewer than a couple of dozen patients will have led to a practice losing thousands of pounds in resources. Ironically this will make it harder for these surgeries to then improve their access, which is not going to benefit patients."
One practice in Northern Ireland with a list size of more than 9,000 has lost all of its funding for patient access. Despite providing both 48-hour access and offering the option for patients to book ahead, the perception of just 3% of its patients has resulted in a loss of approximately £15,000 in funding for services.
A practice in rural Lancashire, with a list size of 14,000, stands to lose £10,000. Less than 1% of its patients answered the questions about 48-hour and advanced access. Of these, 93% were happy with the practice's 48-hour access and 61% were happy with their advanced access.
Dr David Wrigley, a partner at the practice in Carnforth, which also has three other branches in surrounding villages, said: "Our surgery allocates patients to a specific GP because we find that's what most of our patients want, particularly those with long-term conditions.
"But if patients can't get an appointment with me because I'm on leave, or at a different branch surgery, they might perceive it's not good access even though they are always offered an appointment with another GP. The survey doesn't accommodate for this sort of thing and so by trying to provide more personal continuity of care we've ended up being penalised."
Dr Brian Dunn (pictured), Chairman of the Northern Ireland GPC, said: "GPs have always welcomed patient feedback to enable us to improve the services we offer and to continue to deliver high standards of patient care.
"However, despite our repeated warnings that this survey is fundamentally flawed, the previous, more meaningful, practice-based survey was scrapped and this new survey brought in, with the results having devastating effects on some practices.
"If there is evidence to show genuine concerns over access to family doctor services, then we need to know about it, and practices need be supported to improve access, rather than having their funding cut, which will make things even more difficult."
"Some practices will have to choose between making staff redundant or keeping services," Dr Dunn added.
The BMA believes that the disparity between funding in primary and secondary care has been highlighted by this survey approach.
GP Dr Brian Patterson, Chairman of the BMA's NI Council, said: "This bizarre situation, whereby funding has been cut instead of being allocated to GP practices which need to improve access, is in direct contrast to what has happened in our hospitals.
"Poor access to hospital care resulted in vast sums of public money being used to address the situation and reduce waiting times, but in general practice perceived poor access has resulted in resources being taken away."
How did you fare with the Patient Survey? Do results fairly reflect your services? Your comments (terms and conditions apply):
"We fared well, which reflected the past evidence of our inhouse surveys. I am concerned, however, that this could so easily have been very different if patients had not submitted their questionnaires and had not had such a good understanding of the practice. The cost of this survey, the appeals against the unfair results and the time and energy wasted is crazy when we already had a perfectly good method of surveying patients locally. If we are looking for savings in the coming months, surely this is one area that needs review" - Name and address supplied
"We have lost almost £9,000 in funding, from a reponse rate of 1.9%. 74% were happy with 48 hour access although we never turn anyone away!" - Denise Kendall, Havering
"We have been completely unjustly penalised by around £5000 because less than 50 patients from a list of 7,200 didn't know (and didn't ask) that they could book an appointment at almost any time from today to a fortnight time or even further. The PCT flatly refuse to consider the evidence of our system, quoting from the rule book in such a way that it is impossible to effectively appeal their decision. How pathetic, miserly and fundamentally unfair" – Jeremy Betteridge, Penzance
"Our results did not fairly reflect the services and appointments we offer. Being a small practice, just 3,500 – only 41% – of patients responded to the huge questionnaire. Despite offering more surgery hours in response to practice-based survey, this does not reflect in this national survey and this has resulted in a £5000 loss to the practice" – Janice Brook, Coventry
"Not at all, this result will discourage us to improve the access overall. We would not be able to motivate staff to work for this – they will think the monitoring instrument is wrong, then why try to achieve something we will never reach? This is absolutely discouraging results" – Nazma Ansari, Barnet
"Less than 2% of our practice population responded to the survey – 89% of patient were happy with 48-hour access and 69% were happy with the ability to pre-book appointments. Despite this we lost almost £4000 in funding" – Linda Bradley, London