Factors influencing confidence and trust in health professionals: a cross-sectional study of English general practices

Background

Although profound changes to English general practice aim to improve access to appointments, how these might affect patients’ confidence and trust in health professionals is unknown.

Aim

To determine whether appointments that were 1. face-to-face with any type of health care professional, or 2. with general practitioners (GPs) in any mode, were associated with variations in confidence and trust in the professional last seen.

Design and Setting

Practice-level cross-sectional study of 6196 English general practices, 2023-24, using published data.

Method

In a weighted regression model, the outcome was patient-reported confidence and trust in healthcare professionals. The 2 variables of interest were the percentages of appointments with GPs or face-to-face and the 9 covariates were continuity, access, whether patients’ needs were met, the annual appointment rate, practice list size, NHS Region, deprivation, and practice populations’ age and ethnicity.

Results

In the model, higher confidence and trust was associated with higher percentages of patients seen by GPs or face-to-face, also with increased continuity, appointment rates, percentages of patients having their needs met, percentages of patients aged over 18 and percentages of White ethnicity. Confidence and trust was higher in all regions compared to London. Lower confidence and trust was associated with higher deprivation. There was no association with improved access or list size.

Conclusion

This study cannot establish causation but does suggest that strategies to improve access that lower continuity, reduce the percentage of appointments that are with GPs, and increase remote consulting may lead to lower confidence and trust.