{Reference Type}: Journal Article
{Title}: Patients' experiences of GP consultations following the introduction of the new GP contract in Scotland: a cross-sectional survey.
{Author}: Sweeney KD;Donaghy E;Henderson D;Huang H;Wang HH;Thompson A;Guthrie B;Mercer SW;
{Journal}: Br J Gen Pract
{Volume}: 74
{Issue}: 739
{Year}: 2024 Feb 22
{Factor}: 6.302
{DOI}: 10.3399/BJGP.2023.0239
{Abstract}: <B>BACKGROUND: </B>The new Scottish GP contract commenced in April 2018 with a stated aim of mitigating health inequalities.<BR><B>OBJECTIVE: </B>To determine the health characteristics and experiences of patients consulting GPs in deprived urban (DU), affluent urban (AU), and remote and rural (RR) areas of Scotland.<BR><B>METHODS: </B>In 2022, a postal survey of a random sample of adult patients from 12 practices who had consulted a GP within the previous 30 days was undertaken.<BR><B>METHODS: </B>Patient characteristics and consultation experiences in the three areas (DU, AU, RR) were evaluated using validated measures including the Consultation and Relational Empathy (CARE) Measure and Patient Enablement Instrument (PEI).<BR><B>RESULTS: </B>In total, 1053 responses were received. In DU areas, multimorbidity was more common (78% versus 58% AU versus 68% RR, P<0.01), complex presentations (where the consultation addressed both psychosocial and physical problems) were more likely (16% versus 10% AU versus 11% RR, P<0.05), and more consultations were conducted by telephone (42% versus 31% AU versus 31% RR, P<0.01). Patients in DU areas reported lower satisfaction (82% DU completely, very, or fairly satisfied versus 90% AU versus 86% RR, P<0.01), lower perceived GP empathy (mean CARE score 38.9 versus 42.1 AU versus 40.1 RR, P<0.05), lower enablement (mean PEI score 2.6 versus 3.2 AU versus 2.8 RR, P<0.01), and less symptom improvement (P<0.01) than those in AU or RR areas. Face-to-face consultations were associated with significantly higher satisfaction, enablement, and perceived GP empathy than telephone consultations in RR areas (all P<0.05).<BR><B>CONCLUSIONS: </B>Four years after the start of the new GP contract in Scotland, patients' experiences of GP consultations suggest that the inverse care law persists.