Community and Health Research Unit

Members of CaHRU, Dr Coral Sirdifield, Ana Godoy and Prof Niro Siriwardena attended the annual conference of the European Forum for Primary Care (EFPC), ‘Integrated primary care: research, policy and practice’, at the Tobacco Museum in Amsterdam from 30 August to 1 September 2015 to meet with colleagues and present an invited workshop on patient experience at the meeting. Niro Siriwardena is a member of the advisory board of the EFPC and attended a board meeting on the day before the conference.

The workshop, entitled ‘QUALICOPC in the UK, the patient perspective, took place on the first afternoon of the conference and was informed by work from CaHRU on the EU funded Quality and Costs of Primary Care in Europe (QUALICOPC) study. The session was well attended, enabling participants to discuss different approaches for measuring patient satisfaction with primary care and how satisfaction could be improved. Coral and Ana presented an innovative approach called Importance-Performance Analysis, using the QUALICOPC data from England, to demonstrate how the technique could help practitioners, researchers and policy makers to identify where one most needed to focus to improve patient satisfaction.

The conference included excellent keynotes from Prof Chris van Weel, Emeritus Professor of General Practice at Nijmegen (‘The history of Dutch General Practice or: how Primary Care saved the nation’), Dr Isabel Moulon from the European Medicine Agency (‘Bridging the gap between medicine development and clinical practice: is primary care out of the picture?’), Ellen Nolte from the European Observatory on Health Systems and Policies (‘Integrating care: what we know and what we do not know’), Prof John Øvretveit of the Karolinska Institute (‘Priorities for actionable research to speed and spread improvements in caring for chronic illnesses’), Dr Tonka Poplas Susič and Metka Žitnik Šircelj (‘Model practices in family medicine in Slovenia’) and a closing summary from Prof Marc Bruijnzeels of the Jan van Es Institute (‘Challenges for the future of integrated primary care’). A range of parallel research, debate and workshop sessions, lunch on a riverboat and an excellent conference dinner provided a full, interesting and enjoyable programme for delegates.

Teams from the Netherlands Institute for Health Services Research (NIVEL) and the Scuola Superiore Sant’Anna have recently published a paper in the WHO Bulletin, ‘Assessing the the potential for improvement of primary care in 34 countries: a cross-sectional survey (Schäfer et al., 2015). The paper was based on data from the Quality and Costs of Primary Care in Europe (QUALICOPC) study, funded by the EU Framework 7 programme, for which data for England were collected by Dr Sirdifield from the Community and Health Research Unit (CaHRU).

Schäfer et al’s paper draws on data from questionnaires on patient experiences and values relating to general practice assessing what patients from each of the 34 countries felt there was to improve five aspects of primary care: accessibility, continuity, comprehensiveness, patient involvement in treatment decisions, and doctor-patient communication. Overall, the authors concluded that “accessibility and continuity of care show relatively low potential for improvement, while in many countries comprehensiveness was indicated to be a priority area”. Nine countries had a moderate level of improvement potential for patient involvement in decision-making about treatment but all countries performed well on doctor-patient communication. The UK data indicate low patient-perceived improvement potential across all aspects of care with the exception of ‘comprehensiveness’, which had moderate potential for improvement.

The team from CaHRU (Dr Coral Sirdifield, Ana Godoy Caballero, Prof Niro Siriwardena and Dr Karen Windle ) are currently working with colleagues in the College of Social Science (Prof Steve McKay and Dr Christine Jackson) and Nivel (Dr Willemijn Schäfer) to further explore the data for England, investigating how satisfied patients are with primary care by identifying their expectations of care, the extent to which expectations are being met, variations in expectations and experiences, and how patient satisfaction could be improved.

Reference: Schäfer et al., (2015) Assessing the potential for improvement of primary care in 34 countries: a cross-sectional survey, Bull World Health Organ, 93: 161-168. doi: http://dx.doi.org/10.2471/BLT.14.140368

Coral Sirdifield