Patients’ experiences of GP consultations following the introduction of the new GP contract in Scotland: cross-sectional survey

Kieran Sweeney, Eddie Donaghy, David Henderson, Huayi Huang, Harry H.X. Wang, Andrew Thompson, Bruce Guthrie, Stewart Mercer*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Background: The new Scottish GP contract commenced in April 2018 with a stated aim of mitigating health inequalities. Aim: To determine the health characteristics and experiences of patients consulting GPs in deprived-urban (DU), affluent-urban (AU) and remote/rural (RR) areas of Scotland. Design and Setting: Postal survey of a random sample of adult patients from 12 practices who had consulted a GP within the previous 30 days. Methods: Patient characteristics and consultation experiences in the three areas, using validated measures including the Consultation and Relational Empathy (CARE) Measure and Patient Enablement Instrument (PEI). Results: In DU areas, multimorbidity was more common (7888 plt;0.01); complex presentations were more likely (1601 plt;0.01); and more consultations were conducted by telephone (4211 plt;0.01). Patients in DU areas reported lower satisfaction (8206 plt;0.01); lower perceived GP empathy (mean CARE score 38.9 vs 42.1 AU vs 40.1 RR, plt;0.05); lower enablement (mean PEI score 2.6 vs 3.2 AU vs 2.8 RR, plt;0.01) and less symptom improvement (plt;0.01) than those in AU or RR areas. Face-to-face consultations were associated with significantly higher satisfaction, enablement and perceived GP empathy than telephone consultations in RR areas (all plt;0.05). Conclusion: Five years after the start of the new GP contract in Scotland, patients’ experiences on consultations with GPs suggest that the inverse care law persist in deprived areas.
Original languageEnglish
JournalBritish Journal of General Practice
Early online date22 Nov 2023
DOIs
Publication statusE-pub ahead of print - 22 Nov 2023

Keywords / Materials (for Non-textual outputs)

  • general practice
  • Scottish GP contract
  • deprivation
  • remote and rural
  • inverse care law

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