Patient survey to affect GP pay

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Patients are to get the chance to influence about £8,000 of the money their doctor's surgery receives.

The government is to carry out a survey in January of five million patients and ask how good appointment and phone access to their doctor is.

The answers will determine how much of the £8,000 their doctor gets, from up to £72m available to England surgeries.

But the British Medical Association has criticised the move, saying biased questions discredited the survey.

We believe the imposition of these questions will raise patient expectations unfairly Dr Hamish MeldrumBritish Medical Association During the 2005 election campaign, Prime Minister Tony Blair told the BBC's Question Time programme that he was "astonished" to learn some GP surgeries were refusing to set appointments more than two days in advance because of a target that all patients should be seen within 48 hours.

He said then that he would ensure NHS targets did not stop people from seeing their GPs when they wanted to.

Results from this survey are designed to address this issue of flexibility.

Access 'a priority'

The survey could pay out up to £72m to GP practices in England.

An average practice with a list of 6,000 patients would have the chance to earn £8,220 in incentives.

Patients to fill out the postal survey will be selected from those who have had appointments from July to October.

Questions will include:

<ul class="bulletList"><li>In general, are you satisfied with how easy it is to get through to someone on the phone at your doctor's surgery?</li><li>Last time you wanted to, were you able to get an appointment with a doctor more than two full days in advance?</li><li> Last time you wanted to, were you able to make an appointment with a particular doctor, even if it meant waiting longer?</li><li>Over the last six months or so, were you satisfied with the hours your GP surgery was open?</li></ul>

Launching the survey, Health Minister Lord Warner said: "The public has told us that access to GPs is one of their highest priorities, so it's vital we ensure practices are open when the public wants.

"The GP Patient Survey will provide us with a patient's-eye-view of how well GP surgeries measure-up on booking ahead, telephone access and opening times.

"It's no secret GPs have done very well out of the new contract, so now we want to make greater use of patient views as an incentive to GP practices to up their game."

'Leading questions'

But Dr Hamish Meldrum, chairman of the British Medical Association's GPs committee, said the survey was discredited because the government had added "biased questions".

"We reluctantly consented to having some part of practice income dependent on a patient questionnaire about access provided it was based on fair, unbiased questions which we agreed.

"But we believe the imposition of these questions will raise patient expectations unfairly."

He said patients had been asked about arrangements for early morning, evening and weekend surgeries at times when GPs were not expected or paid to be open.

"This survey is in our view totally discredited by the addition of these questions."

Dr Meldrum added: "GPs will continue to consult their patients about their views on the services they provide because we value their opinions and want to try to arrange our surgeries to meet their needs.

"But using a survey containing leading questions, putting words in patients' mouths, and falsely raising expectations, is not the way to do it."