Private providers of out-of-hours GP services deliver poorer care than NHS alternatives, according to a new research.
In the second study in the space of a week to uncover concerns about the quality of private companies working on behalf of the NHS, academics found that patients were more likely to be dissatisfied with their out-of-hours service if it was run by a commercial provider.
Basing their findings on 900,000 responses to the 2012/13 GP Patient Survey, researchers at the University of Exeter Medical School found that NHS providers scored highest on timeliness, patient confidence in doctors, and overall care experience.
Last week a study from Imperial College London found that private providers of in-hours GP services performed worse than traditional GP practices.
Since 2004, evening and weekend GP care has been provided by a variety of NHS, private and not-for-profit providers.
While two thirds of patients say their out-of-hours service is very good, satisfaction rates have been slipping in recent years.
The new study, published in the BMJ, analysed whether the type of provider made a difference. While patient satisfaction with commercial providers was clearly lowest, the reasons were unclear.
“There are variations and examples of good practice among all providers, but the overall trend is that patients report less positive experiences with commercial providers,” said Professor John Campbell, who led the study.
“We now need to understand why that is the case.”
Dr Richard Vautrey, deputy chair of the British Medical Association’s (BMA) GP committee, said that where out-of-hours services had “roots in the NHS”, usually via GP-led co-ops, patients benefited from “continuity and connection” with their doctors.
“This positive environment does not always exist in contracts delivered by the commercial sector,” he said, adding that a recent BMA survey of 15,500 GPs found that only five per cent thought that commercial providers offered good value for money.
Many observers blame changes to the 2004 GP contract, which allowed family doctors to pass on responsibility for providing out-of-hours services to the local health authority, for a decline in evening and weekend services, but many services are still GP-led.
The Conservatives have pledged that GP surgeries should offer appointments from 8am till 9pm seven days a week, but doctors’ leaders say GPs are already struggling to meet current demand, and that the plans will not be achievable without a huge investment in the workforce.
A Conservative spokesman said: “We want patients to receive the best possible care regardless of who provides it. That is why we have brought in an independent Chief Inspector of General Practice who can make judgements about the quality of care without fear or favour.”
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