一般開業におけるスキルミックスの変化：患者の信頼とニーズ充足への認識への影響

BACKGROUND The shift in policy and practice towards multi-professional team working has potential implications for patients' experience. AIM To examine the relationship between delivery of care and patient-reported confidence and trust, and perception of needs met. DESIGN AND SETTING Secondary analysis of data from the General Practice Patient Survey (2023), including 759,149 respondents from 6,418 English GP practices. METHOD Multivariable logistic regression was used to investigate the association between primary outcomes (confidence and trust; perception of needs met) and patient characteristics; and to explore relationships with different combinations of type of health professional, and mode of appointment. RESULTS When patients are uncertain which type of health professional their appointment was with, odds of expressing confidence and trust decreased by 50 to 80% compared to those who saw a GP at their practice. A 50% decrease in the odds of reporting confidence and trust was associated with speaking to a health professional on the phone or by video (aOR 0.56, CI 0.55-0.57, aOR 0.48, CI 0.42-0.55, respectively), compared to patients whose appointment was at their GP practice in person. Similar trends were observed for patient-reported needs met. CONCLUSIONS Patients who are confused who their GP practice appointment was with experience lower trust and are more likely to perceive that their needs are not met: these impacts are magnified when the consultation is remote (phone, video, message). Helping patients understand new roles and providing clarity on who the patient is seeing are essential for building patient confidence in new models of care.