What does the latest GP Patient Survey tell us about socio-economic inequalities in general practice?
Overall patient satisfaction with general practice has improved slightly according to the GP Patient Survey 2024, but remains substantially lower than pre-pandemic levels. Patient satisfaction is not the same across the country. Read more to understand inequalities in patient satisfaction from the latest data.
The General Practice Patient Survey is an annual survey – conducted by Ipsos on behalf of NHS England – that collects patient satisfaction data from each GP practice in England. Our analysis of the 2024 data shows that inequalities in patient satisfaction persist. This is part of a broader pattern with practices in more deprived areas having poorer Quality Outcomes Framework achievement and CQC ratings. Inequalities in patient satisfaction and quality are driven by an unequal distribution of funding, workforce and workload. Our previous analysis shows that practices in deprived areas consistently receive less funding per weighted patient compared to less deprived areas and have fewer full-time equivalent GPs.
Using the 2024 data, we explore four essential axes of patient satisfaction:
- Overall satisfaction: “Overall, how would you describe your experience of your GP practice?”
- Experience of contacting the surgery: “Overall, how would you describe your experience of contacting your GP practice on this occasion?”
- Continuity of care: “How often do you get to see or speak to your preferred healthcare professional when you ask to?”
- Confidence and trust: “During your last general practice appointment, did you have confidence and trust in the healthcare professional you saw or spoke to?”
To explore the relationship between inequalities in patient experience of general practice, we assign each practice to a deprivation quintile, based on its IMD score, at both the national and ICB level. We then calculate the average response for each quintile, in order to reveal patterns in patient experience related to socioeconomic factors.
The following table presents the ICB-level average response to each question, as well as the difference in results between practices serving the most and least deprived populations.
Overall satisfaction
There remains a strong socio-economic gradient according to the latest data. 79% of patients who belong to practices in least deprived areas reported ‘fairly good’ or ‘very good’ overall experience, compared to only 72% in the most deprived areas. The gap has narrowed by 3% since an all-time high of 10% in 2022 and is now the same as the gap in 2017. It should be noted that the survey has changed to an online-first approach and there have been some small changes to the wording of the questions.
There are inequalities across ICBs. Dorset ICB had the highest average overall satisfaction with 82% compared with Bedfordshire, Luton and Milton Keynes ICB with an average overall satisfaction of 67% (see map above).
There are also inequalities within ICBs. For example, in Shropshire, Telford and Wrekin ICB the overall patient satisfaction is relatively good (78%), but there is an 18% difference between practices in most and least deprived areas (see table above). However, in North East London ICB, there is relatively poor patient satisfaction (70%), but the difference between practices in the most and least deprived areas is relatively small. That lack of variation in North East London may reflect widespread socio-economic disadvantage within the ICB, compared to Shropshire, Telford and Wrekin which has a mixture of more affluent and poorer areas.
Experience of making an appointment
There are stark inequalities in patient experience of making an appointment. In 2024, only 65% of people in practices in the most deprived 20% report their experience of making an appointment as good, compared to 73% in the least deprived area. The question has changed this year from ‘making an appointment’ to ‘contacting the surgery’, which makes the trend comparison less relevant. As such, 2024 data is excluded from the chart below to ensure comparability between years.
In 2024, Herefordshire and Worcestershire ICB had the highest patient satisfaction when contacting the practice (78%), compared to Bedfordshire, Luton and Milton Keynes ICB (59%).
Continuity of care
Patients in more deprived areas are less likely to see their preferred health professional compared to less deprived areas. The survey asks, ‘How often do you get to see or speak to your preferred healthcare professional when you ask to?’. Only 38% of patients in the most deprived areas respond always or a lot, compared to 44% in the least deprived areas. Overall continuity of care has improved since last year (from 35% in 2023 to 40% in 2024), although last year’s question asked specifically about seeing GPs.
There remain large differences across the country with Dorset ICB having the highest continuity of care (50%) and Bedfordshire, Luton and Milton Keynes ICB the lowest (32%).
Confidence and trust
Confidence and trust remain high, but socio-economic inequalities remain. 90% of patients in the most deprived areas responded ‘Yes’ when asked if they have confidence and trust in the healthcare professional they spoke to during their last GP appointment, compared to 94% in the least deprived areas. There has been a small decrease over time, but the drop has not been as large as other patient satisfaction metrics. Note that in 2018, the question changed referring to GPs specifically to healthcare professionals generally; as such, 2017 data is excluded from the chart.
Patients in Bath and North East Somerset, Swindon and Wiltshire ICB had the highest trust in the healthcare professional (95%), compared to those in Bedfordshire, Luton and Milton Keynes ICB (89%).