There are ‘alarming’ disparities in patient experiences of primary care, a new report has found.
The NHS Race and Health Observatory has published results from a survey which found that just under half of respondents (49%) had experienced ‘discrimination from their primary care providers based on personal characteristics’.
Former BMA chair and GP Dr Chaand Nagpaul, who launched the report, said it is ‘essential’ that primary care use the ‘deeply concerning’ findings to improve engagement with their diverse communities.
The survey, carried out in 2022 with over 2,680 participants, highlighted a ‘worrying lack of trust amongst certain ethnic minority groups of the service or care that they receive’, according to the Observatory.
It found that a third of South Asian participants say they rarely or never trust primary care to meet their health needs, compared to 16% of White British participants who said the same.
Patients from Bangladeshi, Pakistani, non-British White, and Black communities all reported significantly poorer experiences in primary care compared to White British patients.
The report, based on analysis of the survey data by the University of Oxford, also raised concerns about the ‘lack of medical competence’ and ‘cultural awareness’ around health conditions such as sickle cell disorder or lupus which ‘disproportionately affect ethnic minority communities’.
Responses from women highlighted complaints that primary care providers ‘ignore, or minimise, the reporting of pain’ due to their being a woman or a person of colour.
More findings
- Only half (55%) of participants trust primary care to meet their health needs most or all of the time;
- 38% of Asian participants and 49% of Black participants reported that primary care providers treat them differently due to their ethnicity;
- 31% of Bangladeshi and Pakistani participants felt that, when they do access primary care, healthcare professionals do not act on their concerns;
- Compared with 17.5% of White British participants;
- 25% of all participants felt they were treated differently in primary care due to their ethnicity;
- 51% of those who reported some form of discrimination said it was because of their ethnicity;
- Among Black Caribbean and Black Other participants, over 50% reported discrimination due to ethnicity.
Source: NHS Race and Health Observatory
The report made a number of recommendations for healthcare bodies, including a call for NHS England and the RCGP to ‘raise awareness’ among GPs and other healthcare professionals about racial and ethnic disparities in patient experience.
There should also be continued investment in ‘cultural competency’ training by the RCGP, as well as a framework from the CQC or NHS England to ‘hold healthcare providers accountable’ for addressing disparities, according to the Observatory.
RCGP chair Professor Kamila Hawthorne said that patients ‘must be able to access care without facing discrimination’, and stressed that GPs ‘all have a responsibility’ to recognise that racism continues to be a ‘very real issue’.
She said: ‘This report makes for very difficult reading – it is disheartening to see the number of patients who report negative experiences in primary care.
‘It is critical that all branches of our health service, including general practice, take every necessary measure to prevent this kind of behaviour.’
Professor Hawthorne also pointed to the ‘unprecedented pressure’ GPs are under due to underfunding and ‘poor workforce planning’.
She added: ‘GPs need more time to spend with their patients so that they get the care they deserve. The current Government’s pledges for general practice sound encouraging. We now need to make these promises a reality, otherwise it is our patients who will bear the brunt.’
Dr Nagpaul also called primary care providers to use report findings to improve care for their populations.
He said: ‘It is deeply concerning to hear of poorer experience, racial bias and discrimination faced by patients of ethnic minority groups and the negative impact this has on their engagement with the health service and the care they receive.
‘It is essential the primary care sector use this insight report from patients to improve communication and health care delivery for our diverse population of patients who need support and compassion to equitably support and treat their health needs.’
NHS England said the report’s findings ‘clearly outline an unacceptable variation’ in patient experience of primary care, as ‘all patients, regardless of background, deserve the best care’.
A spokesperson continued: ‘We remain committed to reducing inequalities in care, which is why we are currently working with local NHS organisations to make care fairer for all – and with the government on the upcoming 10-year health plan to build a service fit for the future.’
A version of this story was first published on our sister title Pulse.
