Patient satisfaction with general practice in Scotland 2011/12 to 2021/22.

Area of Science:

• Health Services Research
• Primary Care Medicine
• Public Health Policy

Background:

• The Scottish Government implemented a new General Practice (GP) contract in 2018 to reform primary care and reduce health inequalities.
• The impact of this contract on patient satisfaction remains largely undetermined.

Purpose of the Study:

• To evaluate changes in overall patient satisfaction, access, and consultation quality in Scottish general practices from 2011/12 to 2021/22.
• To investigate disparities in satisfaction across sociodemographic groups over this period.

Main Methods:

• Utilized biennial national Health and Care Experience (HACE) survey data from Scottish patients across six waves (2011/12–2021/22).
• Employed descriptive analyses to track trends in patient satisfaction, access, and consultation quality.
• Measured socioeconomic disparities using the Relative Index of Inequality (RII).

Main Results:

• Overall patient satisfaction with general practice decreased substantially, from 90.1% in 2011/12 to 70.5% in 2021/22.
• Satisfaction was consistently lower in more deprived areas, with the inequality gap widening over time (RII increased from 1.05 to 1.12).
• Declines were most significant for overall satisfaction and access, particularly affecting younger patients and those with multiple long-term conditions, while consultation quality remained relatively stable.

Conclusions:

• Patient satisfaction and access to general practice consultations steadily declined between 2011/12 and 2021/22, with accelerated decreases post-COVID-19, especially for deprived and complex patients.
• The introduction of the new GP contract did not demonstrably alter these negative trends.
• Targeted interventions are crucial to enhance patient satisfaction, particularly for disadvantaged populations, as the contract evolves.