Patient satisfaction with skill mix in primary care: a review of the literature

Abstract

This literature review focuses on patient satisfaction with skill mix in primary care. This is an important, rapidly changing, topic as the range of health professionals working alongside GPs increases and the roles of staff change. The review is intended to assist primary care organizations in developing skill mixes that meet patients' preferences and needs. A number of characteristics that in uence the type of services that patients want were discovered. Older people and those from ethnic minorities want a 'traditional', GP-led service. Access is important to younger people and those in full-time work. Those from lower socioeconomic groups value nurses, but have found the increasingly complex organization of services a problem. There are different levels of knowledge and expectations about health services and information on the skills and knowledge of professionals, what they do and the links between them, needs to be available. A number of aspects of care are important to patients. Patients liked nurses as they were good communicators, formed good therapeutic relationships, gave information on illnesses and spent more time. The location of services is important and patients liked services provided in the home or community. Continuity of care is key, but has been presented as old fashioned and reorganizations may have reduced continuity; skill mix could be viewed as forming a barrier between doctor and patient, but personal lists and teams where practices are divided into smaller units with shared support may help. The competence of health professionals is clearly vital and patients considered nurses competent, although they had concerns about nurses and pharmacists taking on some new roles. The literature focuses on patients' views about doctors and nurses, although they also want a wider range of services and professionals available in primary care: occupational therapy, link workers, CAB advisers, pharmacist advice and mental health workers. Despite being satis ed with nurses, some patients still wanted to see a doctor next time or felt that a doctor should be available. GPs can help build awareness and con dence in patients about the roles and contribution of the team.

Factors associated with the use of primary care services: the role of practice nurses

“…In the case of ethnicity, individuals in different ethnic groups were no more or less likely to visit a practice nurse, while those belonging to Pakistani and 'Other' ethnic groups have a higher probability of visiting a GP, all else equal. This finding appears to be consistent with studies on patient satisfaction with skill mix in primary care that have found [20]. As expected, use of primary care services is positively correlated with the supply of services.…”

Costs and effects of new professional roles: Evidence from a literature review

“…We used the PRISMA checklist to conduct and report the systematic literature review [10]. For the selection of the search terms we inspected the search terms used in previous literature reviews and the keywords of leading papers on the topic of new professional roles [2,[4][5][6]11]. The search strategy included targeted general terms of health service redesign (e.g.…”

Is the co-location of GPs in primary care centres associated with a higher patient satisfaction? Evidence from a population survey in Italy

“…Firstly, patient satisfaction has been found to be related to patient socio-demographic characteristics [39–42] and health conditions [42]. Other factors are related to the GP profile [39–41, 43], as well as the characteristics of general practice, such as the practice size [39, 40], personal list system [39, 40] and practice type [44]. The features of the national health system also influence patient satisfaction [45–47].…”