Polyclinics And Super Surgeries Likely To Undermine Trust And Cooperation Beween Patients And Their GPs, UK

Main Category: Primary Care / General Practice
Article Date: 22 Sep 2008 - 12:00 PDT

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Research carried out at the University of Leicester by Carolyn Tarrant and Tim Stokes, of the Department of Health Sciences, and Andrew Colman, of the School of Psychology, suggests that polyclinics and super-surgeries are likely to undermine trust and cooperation between patients and their GPs.

The research, which is scheduled to be published later this year in the British Journal of General Practice, explored aspects of GP-patient relationships over time. It is published on line on Monday September 22. The findings showed that past experience with a particular GP and expectation of continuing care from the same GP in the future are associated with patient trust and cooperation.

Planned changes to the delivery of primary care in the UK are likely to reduce continuity of care. The new polyclinics and super-surgeries will be staffed by large numbers of doctors, and patients will be unlikely to see the same doctor on every visit.

The research findings are in line with predictions from behavioural game theory. Experiences of past cooperation and expectations of future cooperation -- what game theorists call the "shadow of the future" -- are known to promote trust in continuing relationships of other kinds.

Dr Tarrant commented: "The government is setting up numerous polyclinics, super-surgeries, and walk-in centres all over the country. I'm sure they will have various benefits for patients and GPs, but they are bound to reduce continuity of care, and our research shows that this may lead to a decline in patient trust. If patient trust declines, then medical outcomes may be adversely affected."

The research involved a survey carried out at three Leicestershire (UK) general practices. A random sample of 279 primary care patients who had consulted their GPs over the previous two weeks were posted a questionnaire measuring experiences of trust, interpersonal care, and continuity. Data were analysed using multiple linear regression analysis. Sub-samples of 20 patients and 12 GPs were then interviewed in depth, and the interviews were analysed using qualitative methods.

Patients' judgements of the GPs' interpersonal care, past experience of cooperation, and expectation of continuing care from the same GP were all found to be independent predictors of patient trust. The findings highlight the value of continuity in GP-patient relationships.

The study was funded by The University of Leicester School of Medicine Research Committee.

University Of Leicester

A member of the 1994 Group of universities that share a commitment to research excellence, high quality teaching and an outstanding student experience.

- Ranked top for student satisfaction in England (jointly with Oxford) among mainstream universities (average score of 4.4 out of 5 for overall satisfaction)

- Ranked as a Top 20 university by The Sunday Times University Guide, The Guardian University Guide and the UK Good University Guide

- One of just 23 UK universities to feature in world's top 200- Shanghai Jiao Tong International Index, 2005-07.

- Ranked in top 200 world universities by the THES (Times Higher Education Supplement)

- Short listed University of the Year in 2007 by The Sunday Times and Short listed Higher Education Institution of the Year - THES awards 2005 and 2006

- Ranked top 10 in England for research impact by The Guardian

- Students' Union of the Year award 2005, short listed 2006 and 2007

Founded in 1921, the University of Leicester has 19,000 students from 136 countries. Teaching in 18 subject areas has been graded Excellent by the Quality Assurance Agency- including 14 successive scores - a consistent run of success matched by just one other UK University. Leicester is world renowned for the invention of DNA Fingerprinting by Professor Sir Alec Jeffreys and houses Europe's biggest academic Space Research Centre. 90% of staff are actively engaged in high quality research and 13 subject areas have been awarded the highest rating of 5* and 5 for research quality, demonstrating excellence at an international level. The University's research grant income places it among the top 20 UK research universities. The University employs over 3,000 people, has an annual turnover of £184m, covers an estate of 94 hectares and is engaged in a £300m investment programme- among the biggest of any UK university.

University Of Leicester