Influences on patient satisfaction survey results: is there a need for a rethink?

Background: Patient experience is a key principle of the NHS and is increasingly linked to payment of providers.

Aim: To establish if any correlation exists between patient satisfaction scores (as measured in the MORI survey) and practice list size or deprivation score.

Method: This was a retrospective correlation review using data for general practices in Derbyshire County Primary Care Trust extracted from existing publicly available sources. Correlation between satisfaction score and both deprivation index and practice list size was examined.

Results: Data from all 96 practices were reviewed. Overall satisfaction showed a statistically significant negative correlation with deprivation (r=-0.28, P=0.006). Neither question pertaining to QOF payment showed a correlation with deprivation, however, there was a statistically significant negative correlation with list size (Q5a r=-0.52, P <0.01. Q7 r=-0.43, P <0.01). Questions regarding satisfaction with the doctor showed weak but statistically significant negative correlations with deprivation, (r varying from -0.21 to -0.39, P <0.05). Satisfaction with nurses showed positive correlations with deprivation, with satisfaction increasing in line with deprivation (r varying from 0.24 to 0.36, P <0.05). Regarding list size, for nurse care the reverse was seen, with increased list size being linked to decreased satisfaction (r varying from -0.21 to -0.45, P <0.05).

Conclusion: Although variables showed weak correlations, there were correlations between list size and deprivation in the results of the patient experience questionnaire. Linking this to payment has implications for primary care contracting.