Changes in public satisfaction with GP services in Britain between 1998 and 2019: a repeated cross-sectional analysis of attitudinal data

Abstract

Background: Between 1998 and 2019, the structure and process of general practitioner services in Britain underwent a series of reforms and experienced distinct funding environments. This paper examines changes in satisfaction with GP services over time against this backdrop. Methods: Data were extracted from the British Social Attitudes Survey for the period 1998–2019. Logistic regression analyses investigated changes in overall satisfaction and among specific population sub-groups differentiated by socio-demographic characteristics whilst taking account of time trend and interaction effects between sub-group membership and time trend. Results: Sustained and significant changes in satisfaction coincided closely with changes to the funding environment. Distinct patterns were evident among sub-groups. Satisfaction appeared to fall more sharply during austerity for low income groups, older people and people who had fewer formal qualifications/years in education. Conclusion: While a series of policy initiatives were adopted over the period examined, public satisfaction seemed to move in a manner consistent with levels of government expenditure rather than exhibiting distinct breaks that coincided with policy initiatives. As services recover from the pandemic it will be necessary to invest in a significant and sustained way to rebuild public satisfaction.