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

Abstract (English)

BACKGROUND: Profound changes to English general practice aim to improve access to appointments, however, how these changes might affect patients' confidence and trust in healthcare professionals is unknown. AIM: To determine whether appointments that were 1) face to face with any type of healthcare professional, or 2) with GPs in any mode, were associated with variations in confidence and trust in the professional last seen. DESIGN AND SETTING: A practice-level cross-sectional study of 6196 English general practices was conducted from 2023-2024, using published data. METHOD: In a weighted regression model, the outcome was patient-reported confidence and trust in healthcare professionals. The two variables of interest were the percentages of appointments with GPs in any mode or face to face any healthcare professional and the nine 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 in any mode or face to face any healthcare professional, also with increased continuity, appointment rates, percentages of patients having their needs met, percentages of patients aged >18 years, and percentages of White ethnicity. Confidence and trust was higher in all regions compared with 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 in healthcare professionals.