Limited impact on patient experience of access of a pay for performance scheme in England in the first year

Figures & data

Table I. Median and interquartile range (IQR) of practice characteristics and mean and standard deviation (SD) of characteristics of patients responding to the access surveys, 2006/07 and 2007/08.

Practices (n = 222)	2006/07 Median (IQR)	2007/08 Median (IQR)
Patients per practice	6359 (3718, 10185)	6553 (3853, 10291)
Patients per fte GP	1799 (1455, 2203)	1821 (1456, 2216)
IMD 2007^a	15.8 (9.7, 27.0)	15.8 (9.7, 27.0
Training practices (n)	43	43
Patients	Mean (SD)	Mean (SD)
Mean practice response rate (%)	49.5 (10.8)	44.5 (9.4)
% of respondents aged 65 years or older	29.6 (8.9)	28.0 (7.9)
% of respondents who were male	41.9 (5.0)	43.8 (4.8)
% of respondents reporting non–white ethnicity	14.2 (24.7)	14.2 (24.6)
Mean number of patients per practice on practice coronary heart disease registers	234.7 (162.9)	236.8 (162.7)
% of survey respondents reporting five or more appointments with a general practitioner in the past year	32.9 (8.8)	28.0 (7.5)

^aHigher scores for IMD 2007 indicate greater socioeconomic deprivation.

Table II. Patient experience of access 2006/07 and 2007/08 (mean percentages and 95% confidence intervals of percentages of patients per practice reporting positive experiences).

	All practices (n = 222)			Practices with ≥35% of patients from ethnic minority groups (n = 24 practices)
	2006/07 (95% CI)	2007/08 (95% CI)	Diff (95% CI)	2006/07 (95% CI)	2007/08 (95% CI)	Diff (95% CI)
% satisfied with phone access	83.8 (81.9, 85.6)	85.1 (83.5, 86.7)	1.31 (0.45, 2.18)	72.8 (66.4, 79.2)	75.5 (69.2, 81.8)	2.96 (0.22, 5.69)
% able to get appointment within 48 h	87.0 (85.8, 88.2)	88.3 (87.2, 89.4)	1.25 (0.44, 2.07)	82.4 (79.0, 85.8)	83.3 (79.8, 87.8)	1.12 (−1.22, 3.47)
% able book advance	68.4 (65.5, 71.2)	72.1 (69.6, 74.5)	3.69 (2.42, 4.97)	63.0 (56.2, 69.9)	67.8 (60.9, 74.7)	4.42 (−0.19, 9.03)
% able to see a particular GP	85.4 (84.1, 86.7)	85.2 (84.0, 86.5)	−0.16 (−0.93, 0.61)	73.4 (69.2, 77.7)	75.2 (70.2, 80.2)	1.21 (−2.62, 5.04)
% satisfied with opening hours	83.4 (82.4, 84.3)	81.1 (80.2, 82.0)	−2.28 (−2.8, −1.7)	75.4 (71.3, 79.6)	74.4 (70.2, 78.5)	−1.25 (−3.46, 0.96)

Table III. Prediction of access scores in 2007/08 by patient and practice characteristics (general linear models, backward stepwise regression used to eliminate non-significant predictors, rationalized arcsine transformation of dependent variables).

	β (95% CI)	P	Interpretation of coefficient^a
Satisfied with opening hours
% Ethnic minorities	−0.14 (−0.18, −0.10)	<0.0001	−1.4%
Practice list size	−0.0003 (−0.0005, −0.0001)	<0.0001	−0.3%
% five or more appointments	0.24 (0.14, 0.35)	<0.0001	2.4%
r^2 0.25
% able to see a particular doctor
% Ethnic minorities	−0.1 (−0.15, −0.04)	0.0002	−1.0%
IMD 2007	−0.24 (−0.35, −0.13)	<0.0001	−2.4%
Practice list size	−0.0005 (−0.0007, −0.0002)	<0.0001	−0.5%
r^2 0.27
% able to book an appointment in advance
IMD 2007	−0.32 (−0.48, −0.16)	<0.0001	−3.2%
Practice list size	−0.0007 (−0.001, −0.0003)	0.0005	−0.7%
r^2 0.09
% satisfied with phone access
% Ethnic minorities	−0.12 (−0.19, −0.04)	0.001	−1.2%
IMD 2007	−0.29 (−0.43, −0.14)	0.0001	−2.9%
Practice list size	−0.0009 (−0.002, −0.0005)	<0.0001	−0.9%
r^2 0.26
% able to see a GP in 48 h
% Ethnic minorities	−0.06 (−0.12, −0.008)	0.03	−0.6%
IMD 2007	−0.19 (−0.31, −0.07)	0.002	−1.9%
Practice list size	−0.0005 (−0.0008, −0.0002)	<0.0001	−0.5%
r^2 0.15

For predictors which are percentages (ethnic minorities and five or more appointments) the column 3 value represents the change in the per cent of patients satisfied when there is a 10% increase in the predictor variable.

For IMD 2007, the column 3 value represents the change in the percent satisfied when there is a 10 unit increase in IMD 2007.

For Practice List size, the column 3 value represents the change in the percent satisfied when there is a 1000 persons increase in the practice list size.

^aColumn 3.