January 2003

From BMJ-British Medical Journal

Patient expectations of care may exceed government targets

Setting standards based on patients’ views on access and continuity: secondary analysis of data from the general practice assessment survey BMJ Volume 326, pp 258-60

Patients may have expectations for access to primary care in excess of current government targets, finds a study in this week's BMJ. Patients also have high expectations of continuity of care.

Researchers analysed data from general practice research studies and routine quality assessment activities undertaken by practices and primary care trusts. The analysis involved 21,905 patients.

Satisfactory standards of access were next day appointments with general practitioners and a 6-10 minute wait for consultations to begin. A satisfactory level of continuity was seeing the same general practitioner "a lot of the time."

Standards varied with the analytical methods used and by sociodemographic group. Patients from ethnic minorities generally had higher standards whereas older patients (aged 46 to 60 years or more) had lower standards.

Patients have high expectations relating to access of care, which may support or exceed current government targets, including the standard for waiting times by 2004 of seeing a general practitioner within 48 hours, say the authors.

However, it is unclear the degree to which such standards are reliable or valid, how conflicts between access and continuity should be resolved, or how these standards relate to other priorities of patients, they conclude.