Understanding the volume and content of general practice consultations: the 5th National Morbidity Study
Joint led by Professors Chris Salisbury and Richard Hobbs. Team members: Profs Louise Robinson, Irwin Nazareth, Kath Checkland, Barbara Hanratty, Matt Sutton and Christian Mallen, Drs Rafael Perera, Clare Bankhead, Tim Holt, Irene Petersen, Rupert Payne and Nadeem Qureshi.
General practice is central to provision of care in the NHS. Yet we know remarkably little about what goes on in general practice – who consults, how often, or with what sorts of problems. Most of the information we have comes from the Fourth national morbidity study, conducted more than 20 years ago. Since then general practice has changed hugely. The aim of this is study is to describe the types of problems presented to GPs by different groups of patients, and how this varies in different practices. We will explore how levels of general practice workload are associated with quality of care, patient satisfaction, and use of hospitals.
We will use a large dataset of patient records from general practice. We will obtain records for
250,000 randomly selected patients from about 370 practices, linked to routinely available data about practice characteristics, patient satisfaction, quality of care, hospital admission rates and death rates in those practices. All data will be anonymised. Researchers cannot identify any patients or practices.
In the first phase of work (funded by NHS England) we will use the same data to understand
consultation rates in general practice. This second phase will mirror the previous national morbidity surveys so that we can compare findings to understand how general practice consultations have changed over the last 20 years. We will then combine the findings from the first and second phases to explore whether practices with higher workload have higher or lower rates of hospital admissions, and provide better or worse quality of care or patient satisfaction. We will explore whether certain types of practices are able to see more patients while also maintaining quality and patient satisfaction.
The findings from this study will have implications for decisions about the organisation of general practice, and will be of great importance to patients, policy-makers, researchers and GPs themselves.