General Practice Satisfaction

Do we really know why patients are unhappy with their GP practice?

Betweenness centrality in the GP appointments systemNetwork diagram of 26 variables in the GP appointments system. The ten most central sit on a rising diagonal from Operational Process Effectiveness at lower left to Appointment Wait Time at upper right, with their driver variables beneath. Appointment Wait Time is the largest and darkest node, lying on more of the network’s shortest paths than any other variable and sitting on seven of the fourteen feedback loops. Appointment Wait Time Patient Satisfaction Patient Demand for GP Appointments Same-day (Urgent) Demand Severity of Untreated Conditions Repeat Visits for Unresolved Problems 8am Phone Scramble Share of Slots Held for Same-day Use Missed Appointments (DNAs) A&E and Walk-in Attendance Triage and Signposting Pharmacy and Neighbourhood Care GP Capacity (Appointment Supply) Workload per GP Non-GP Clinical Roles Rushed, Shorter Consultations GP Burnout and Attrition Attractiveness of Posts to Applicants Practice Profit (Partner Income) NHS Payments and Other Revenue Operational Process Effectiveness Motivation to Seek Improvements Reputation of Practice Ageing Population and Chronic Disease Funding and Workforce Pipeline Lags Unattractive Locations Appointment Wait Time Patient Satisfaction Patient Demand for GP Appointments Same-day (Urgent) Demand Severity of Untreated Conditions Repeat Visits for Unresolved Problems 8am Phone Scramble Share of Slots Held for Same-day Use Missed Appointments (DNAs) A&E and Walk-in Attendance Triage and Signposting Pharmacy and Neighbourhood Care GP Capacity (Appointment Supply) Workload per GP Non-GP Clinical Roles Rushed, Shorter Consultations GP Burnout and Attrition Attractiveness of Posts to Applicants Practice Profit (Partner Income) NHS Payments and Other Revenue Operational Process Effectiveness Motivation to Seek Improvements Reputation of Practice Ageing Population and Chronic Disease Funding and Workforce Pipeline Lags Unattractive Locations LEAST CENTRAL MOST CENTRAL NODE SIZE AND TONE = BETWEENNESS 0 24 273 LINK WIDTH AND TONE = EDGE BETWEENNESS 2 40 134 LINK STYLE moves in the same direction (+) moves in the opposite direction (−) effect arrives after a delay Links between the top ten arc above the line, arc height set by how far apart they sit. Drivers and their links are unchanged. Appointment Wait Time carries more of this system than any other variable — it sits on seven of the fourteen loops, so anything that shortens it pays back seven times over.
Betweenness centrality in the GP appointments system. Node size and tone show how many of the network’s shortest paths run through each variable; link width and tone show the same for each connection. Tap or click to enlarge.