THE PATIENTS VIEW OF GENERAL-PRACTICE FUNDHOLDING - RESULTS OF A CROSS-SECTIONAL SURVEY

We report the results of a survey of patients' awareness, attitudes an d satisfaction regarding fundholding and related developments in prima ry care, and compare the responses of patients in fundholding and non- fundholding practices. (Six total fundholding general practices and tw o non-fundholding general practices in West Berkshire were included.) An anonymous postal questionnaire was sent to 1150 patients with joint pain aged 17-80, of whom 715 (63%) returned completed questionnaires. Few (17%) fundholding respondents had received information from their practice about fundholding or (36%) were aware of new or different se rvices being offered but the majority had heard of fundholding and wer e able to describe it accurately. Satisfaction with GP services was hi gh in both types of practice, but fundholding patients reported higher levels of satisfaction with getting a referral to a hospital speciali st (FH: 81% vs. NFH: 63%), and with the length of time between referra l and treatment (FH: 81% vs. NFH: 59%). A majority of patients in both types of practice wanted to be involved in decisions about the servic es available to them but only a third of patients thought that fundhol ding would make this easier. Fundholding patients were more likely to report being given enough choice about treatments available to them (5 1%) than their non-fundholding counterparts (35%). Fundholding patient s had not perceived a reduction in quality of care as a result of budg etary pressures and were more satisfied with the process of referral t o secondary care than their counterparts in non-fundholding practices. Patients in both types of practice felt that it was important to be i nvolved in decisions about the services available to them, but few tho ught that this would be more likely as a result of fundholding. Provis ion of information to patients is a prerequisite for their involvement , but judging by the number of patients receiving any information abou t fundholding from their practices this aspect of the reforms does not seem to have been implemented.