What do patients and the public want from primary care?

doi:10.1136/bmj.331.7526.1199

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Angela Coulter (angela.coulter@pickereurope.ac.uk), chief executive1

¹Picker Institute Europe, Oxford OX1 1RX

The government hopes that getting patients' views on their priorities for primary care will ensure support for its plans. It is likely to find patients care more about quality of care than structural or financial reform

Introduction

The UK government has stated it wants the public to help shape the future of the health service. In the run-up to the planned publication of a white paper on care outside hospitals, Patricia Hewitt, secretary of state for health in England, is leading a big public engagement exercise to “genuinely involve patients, public and staff in designing family health and social care to meet the challenges of the 21st century.”1 The secretary of state's commitment to engaging directly with the public is commendable if it is a genuine attempt to listen and learn, but she should also take account of the extensive body of research evidence on what patients and the public want. Patients have diverse needs and expectations leading to different, and some-times conflicting, views on priorities,2 but it is possible to discern themes. What does the evidence show?

Structure of primary care

A distinction can be made between what patients want as individual healthcare users and what they hope for as citizens or taxpayers (box 1). In general, patients care more about the quality of their everyday interactions with health professionals than about how the service is organised. Furthermore, although there is scope for improvement in primary care, changes that seem to undermine the founding principles of the NHS are likely to be strongly resisted.

National Citizens summit organised to get patients' views on health care

Credit: dh

Interpersonal care

Patients want primary care professionals who are good communicators and have sound, up to date clinical knowledge and skills. They also want professionals who are interested and sympathetic, involve them in decisions, give them sufficient …