Ninth on the list was Porlock Medical Centre in Somerset. Dr Ian Kelham, a GP there, says staff practise family medicine in the old-fashioned sense. Many live locally and they know their patients. ‘We’ve invested heavily in nurses and work as a really close team,’ he says. They make an effort to be welcoming and accommodating.
A key factor is probably location. Porlock Medical Centre, like the other GP surgeries that made the top 10, is in a quiet area, serving a small community. City practices can only dream of getting to know their patients in the same way.
The survey also found that patient satisfaction, though pretty high, appears to be modestly shrinking, with 46.5 per cent of people rating their practice as ‘very good’ in 2012, dropping to 43.1 per cent this year.
So what else can surgeries do to achieve Porlock levels of patient satisfaction?
A good answer to this question is found in a 2013 report commissioned by NHS England.
Its authors, using responses from 512 medical professionals and patients, concluded that most patients did not want choice, but rather high-quality, locally available care.
To make the service work, the researchers said that GP appointments should be extended to a minimum of 20 minutes if doctors were to look after patients who had long-term conditions or complex needs.
Essentially, GPs needed to see fewer patients, for longer, without the fear that their funding would be cut.
Unfortunately, if the key to patient satisfaction is the availability of GPs, then things are unlikely to get better. A study by the King’s Fund released in May found that workload had become more complex and intense over the last five years and GP recruitment had not kept pace with the increase in demand.
The report pointed out that, as GP practices tried to handle the increasing number of consultations, they used other staff, like nurses, to treat the less complicated cases. This left doctors with just the harder cases that could not be dealt with during a 10-minute appointment.
An additional problem is understaffing, with many GPs leaving the profession. The researchers surveyed trainee GPs and found that only one in 10 planned to be working full time and seeing patients five years after qualifying. At the other end many older doctors are choosing to retire early.
With fewer GPs serving ever more patients, the revival of old-fashioned family medicine doesn’t seem that likely.