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General practice ‘in decline’ as satisfaction drops to record lows

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Satisfaction with GP services has dropped to the lowest levels since records began, with respondents citing waiting times and staff shortages as reasons

Public satisfaction with general practice has fallen to its lowest level since records began, according to the British Social Attitudes (BSA) survey.

The annual survey, which started in 1983, revealed that satisfaction dropped by seven points last year to 65%. Meaning, that for the first time, general practice is not seen as the best NHS service. In 2009 its satisfactory rating was 80%.

The survey – of 3004 people in England, Scotland and Wales – was conducted by the National Centre for Social Research and was analysed by the think tanks Nuffield Trust and the King’s Fund. Reasons for the drop in satisfaction include staff shortages, waiting times, funding concerns and government reforms.

Ruth Robertson, fellow at the King's Fund, said: ‘The public used to put GPs on a pedestal. But since 2009, when there was an 80% satisfaction rating, it has been steadily declining.

‘It shows the impact of the huge pressure on GPs and the public is responding to that.’

Speaking to the BBC, Prof John Appleby of the Nuffield Trust, said: ‘These results should make the government sit up and take notice.

‘If they want to see satisfaction rise, my suggestion is they should think seriously now about more money for healthcare over the next few years.’

Ms Robertson said the results risked general practice’s reputation as the ‘jewel in the crown of the NHS’ and that ‘the data sends out an unmistakable message that general practice is in decline’.

The fall in satisfaction was recorded across all age groups, with the over-65s being only marginally more satisfied as ‘they see GPs more often so build up a stronger personal relationship with them’.

The survey also showed an overall fall in the satisfaction with the NHS as a whole. Public satisfaction fell 6% since 2016 to 57% – the lowest since 2011.

Dissatisfaction, which the BSA measures separately, rose to 29% – the highest level since 2007.

‘Despite mounting pressure on the NHS, satisfaction in the health service has remained high in recent years, with satisfaction staying above 60% for most of this decade. In the last year, however, the tide has started to turn,’ said Prof Appleby.

‘The drop in satisfaction and rise in dissatisfaction this year suggest that the public are worried about the NHS.’

And Mr Appleby’s assertions are confirmed by the survey’s results. The share of voters who believe the NHS receives too little funding from the government jumped from 39% in 2015 to 51% in 2017.

‘Ministers must act urgently on public concerns over NHS understaffing,’ said Janet Davies, Chief Executive of the Royal College of Nursing (RCN).

She said that staffing issues and cuts to training budgets were ‘leaving existing staff frustrated and demoralised, and cuts to student funding have led to a worrying fall in applications – we are losing the nurses of the future.’

Ms Robertson was eager to stress that the service was still highly valued: ‘More people are satisfied with the NHS than are dissatisfied. They showed really strong support for the core value principles of the NHS.

‘I think this shows that it is not falling out of favour, but people are worried about the NHS and they are worried about funding and staffing shortages.’

A February poll by Ipsos/Mori showed that almost half the public (48%) thought that the biggest issue facing the UK was the state of the NHS – more than the 46% who identified Brexit as their main concern.

Chairwoman of the Royal College of GPs, Prof Helen Stokes-Lampard, said that the very disappointing figures were ‘hardly surprising’ due to the ‘inevitable effects of a decade of underinvestment in our family doctor service.’

A spokesman from the Department of Health and Social Care said: ‘Just last year, the NHS was rated as the best and safest health system in the world by independent experts and, as this report itself points out, the majority of patients are satisfied with the NHS.’

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