Pfizer/MORI Health Choice Index - Public Opinions On Choice In Out Of Hospital Care

The inaugural Pfizer/MORI Health Choice Index provides encouraging findings for the Government's policies relating to the introduction of more choice and contestability in healthcare.

Almost two in five people (38%) in England feel there is not enough choice of health services outside hospitals and around three in five (59%) believe increasing choice will have a positive impact on quality of healthcare.

Whilst the Index reaffirms that people support the concept of choice, and that some want more -- particularly younger, middle-aged and more affluent groups -- it highlights that in practice, many people are content to use their GP for most things. The GP remains the first choice for serious health concerns, especially worrying health problems (78%) and treating long-term conditions (68%), and as a source of information and advice about how to live healthily (36%).

Access to GPs is critical for those with long-term conditions -- the majority say the GP is their first choice for managing their condition (71%). This reflects the greater emphasis they place on continuity of care, and the value they place on GP involvement in the important and complex healthcare choices that affect them.

A worrying majority feel they know little or nothing at all about local healthcare services outside hospitals (55%). This is a concern as men and the less well-off are less confident when choosing new health services. Whilst the GP is patients' first choice for information and advice, 46% prefer to seek information from other sources. The GP needs to maintain a central role in primary care, not only as a provider of care, but also to help patients interpret information so they can choose the best possible care.

Around half of the public say they would choose an alternative provider for treatment of minor ailments, compared to 31% who would choose their own GP. Pharmacists are the most popular alternative provider (36%) due to location, ease of access and ability to see someone straight away -- a higher proportion than have used a pharmacist in the past year (28%). There was little demand (5%) for 24-hour GP services to treat minor ailments. Interestingly, of the 50% who would choose an alternative provider for minor ailments, half said they would in principle be willing to pay a small amount for that choice.

This research also illustrates the potential for choices, at least in the first instance, being taken up differently by different groups, whether defined by age, sex, social class or geographical location, and those with or without long-term conditions. In order for new services to be understood, accessed and used appropriately by everyone, communication about, and information on services needs to use multiple media and routes. And, certainly at first, confidence will be increased if these services are positively supported and their usage advised upon via the patient's trusted GP.

Technical details

• Results are based on face-to-face interviews with a representative sample of 1,016 adults aged 16+ in England and a booster sample of 492 adults with long-term health conditions in England.
• Fieldwork took place between 17th September and 28th October 2005.
• The survey was conducted among adults in a random selection of 169 OA based sample points across England, with quotas set according to 2001 Census profiles in each OA area.
• Data are also weighted according to up-dated profile information.