Episodes

  • Choosing general practice: What shapes medical student decisions?

    Choosing general practice: What shapes medical student decisions?
    May 12 2026
    Today, we’re speaking to Catharina Savelkoul, a DPhil student in Health Economics based at the Nuffield Department of Primary Care Health Sciences at the University of Oxford.Title of paper: Factors Influencing UK Medical Students’ Choice of General Practice: A Systematic ReviewAvailable at: https://doi.org/10.3399/BJGP.2025.0226The UK faces a projected shortage of approximately 15,000 GPs by 2036/37, with a declining proportion of UK medical graduates pursuing general practice. Previous research has identified various contributing factors but lacked a contemporary synthesis within a coherent theoretical framework. This systematic review examines factors influencing UK medical students' career decisions, finding three critical influences: curricula that inadequately represents general practice, a persistent negative hidden curriculum, and the impact of clinical placement quality. Our revised Bland-Meurer model incorporates these findings, providing a comprehensive framework to improve GP recruitment. This systematic review identifies the factors that shape UK medical students’ intentions toward general practice.TranscriptThis transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions.Speaker A00:00:01.120 - 00:00:59.530Hi and welcome to BJJP Interviews. I'm Nada Khan, one of the associate editors of the bjjp. Thanks for listening to this podcast today.In today's episode, we're speaking to Katharina Savalcool. Katharina is a DPHIL student in Health Economics based at the Nuffield Department of Primary Care Health Sciences at the University of Oxford.We're here today to talk about the paper she's recently published in the BJJP titled Factors Influencing UK Medical Students Choice of General A Systematic Review. So, hi Katharine, it's lovely to meet you and to talk about your work.This is a super interesting area to study because we know that there is a push to increase the number of GPs in practice and I guess that does really start from medical school and people's intentions there. But just to start off, could you talk us through why you decided to do this work and what were you aiming to look at here?Speaker B00:01:00.050 - 00:03:17.090Yeah, of course.So the goal of this piece of research, of the systematic review was to synthesize the empirical evidence on the factors that influence medical students, GP, career intention. Because we know that the general practice is what makes the NHS functions.It handles over 300 million consultations annually, manages the long term, most long term conditions, issues over a billion prescriptions per year. And we also know that healthcare systems with a strong, with strong primary care achieve like, better population health in general.But at the same time, right now the projected shortages for the UK are approximately 15,000 GPs by 2036, which is of course a large number and shows like a workforce crisis. And then if we look at the policy response to this, they've been like quite ambitious but also largely unsuccessful.So for instance, Health Education England mandated that 50% of all new medical graduates should enter general practice. And this target has never been met. The same goes for the NHS long term workforce plan to increase GP training places by 50% to 6,000 places in 2031.And the interesting part about this is that the policy responses are all about setting this goal. Right?It's about, you know, we're shifting, we're shifting care to the community, we're expanding training places, more medical students should become a gp. But that's all. Yeah, setting like these, these, these strategies, but at the end it almost seems like the, we're achieving the reverse.So that, that kind of brought me to the question of if we want to, you know, make sure that we have a healthy primary care workforce, that the general practice avoids this large crisis in the future, then maybe Instead of setting these ambitious goals, we should look into the question of what draws medical students to the general practice and also what are some of the reasons why they might not become a gp?And I think if we zoom into those factors at medical school, during medical education, you get a lot more interesting insights that can actually inform more effective policy. I think that's the kind of. That was the reason I conducted this systematic review.Speaker A00:03:17.970 - 00:03:42.850That's a great summary of what's been going on with GP recruitment in the past little while in terms of policy and the push to increase the number of gps. And this was, as you mentioned, a systematic review that followed pretty conventional review processes.But I wonder if you could tell us a bit about this bland mirror model. It's a framework used in terms of organizing the results and how this informed how you structured the results.Speaker B00:03:43.990 - 00:04:47.410Yeah, I think it's for this specific research question, looking into factors...
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    16 mins
  • Looking back at the BJGP Research Conference 2026

    Looking back at the BJGP Research Conference 2026
    Mar 24 2026
    Today, we’re going to back at the recent BJGP Research Conference, which was held just last week on the 20st of March 2025 in Bristol. TranscriptThis transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions.Speaker A00:00:00.960 - 00:00:39.550Hello and welcome to this BJGP podcast. I'm Nada Khan and I'm one of the Associate Editors of the Journal. Thanks for listening today.In today's episode we're going to look back at the recent BJGP Research Conference which we held just last week on 20th March in Bristol. It was absolutely brilliant to welcome the BJGP team and people who attended to the Southwest.And in today's episode I'm just going to talk about some the highlights and really focus on what the conference is about and maybe have a chat about how to get involved in the future. But first, here's a welcome to the conference from our Editor in Chief, Ewan Lawson.Speaker B00:00:40.270 - 00:01:16.520My name's Ewan Lawson, I'm editor of the bjgp. So that means basically I'm the one person that the Journal would probably run without and everyone else does all the work.But I do have to stand up here and say hello to you and I want to offer you the warmest of welcomes to the conference. Been running this for a few years and it's always really nice to get together and just try to help each other, you know, get involved.It's not in a very scholarly way, you know, whether you're involved in research or whether you're interested in putting research into practice. We think we can offer you quite a lot more than just the fact that we publish research at BJGP and BJGP Open. So I hope you have a fantastic day.Speaker A00:01:17.320 - 00:03:26.850So this was the seventh run of the BJGP Research Conference and this year we had a particular focus on a few different areas.We took a bit of a deep dive into patient involvement, new and emerging research in general practice, general practice policy and how to get research into impact. And this year, as always, quite a bit around writing and also public speaking in academia.The conference kicked off this year with an absolutely brilliant talk by Professor Martin Marshall, who some of you may know as the Chair of the Nuffield Trust. But he's also Emeritus professor of Healthcare Improvement at UCS and non Exec Director at the Royal Devon University Healthcare trust.And until 2022, Martin was also the Chair of the Royal College of GPs and a GP in New East London. So definitely someone worth listening to about his experiences as well.And Martin really focused in his talk on the relationship between general practice and policy and asked a really important question, which is how good are we as a profession at influencing decision decision makers?And in his talk, Martin reflected on the fact that while the value of general practice is really well established for patients, communities and the wider nhs. It's often still misunderstood or undervalued at a policy level.And in his talk he challenged whether that's purely down to policymakers or whether, as Julian Tudor Hart once put it, there's also an element of political literacy within the profession itself.And what really followed was a thoughtful discussion about how both national leaders and individual clinicians can do more to shape policy, and whether that's through better communication, stronger advocacy, or even engaging more actively with the systems around us. It was a really thought provoking structure of the conference and linked closely to that broader theme of impact that ran throughout the day.Here's just a short snippet of Martin speaking at the conference.Speaker C00:03:27.570 - 00:04:45.260I wish I could have my career again and I'd be more influential than I was. I've learned a lot along the way, but this is what I've learned. First of all, as I've described, influencing is about far more than informy.It's not about telling, it's about getting inside people's heads and understanding what's important to them. A lot of influencing is about timing. How do we decide when to influence? I think it's really important. Policy windows is an interesting concept.So sometimes just a window opens that allows you to do something.And a good example of this would be the evidence around Continuity of care, which is actually pretty strong in General practice was largely ignored by policymakers and politicians until the pandemic came along and they were looking for a way of delivering the vaccination program. And we made the case based on evidence that trust is really important to the success of uptake of vaccination programs.And that's why government decided that general practice would deliver their program largely, rather than setting up a separate body to deliver it. So there's an example, another example of ways of change.The NUFRE is doing some really important work around the distribution, the resource distribution formula for general practice, something ...
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    12 mins
  • Skill mix and patient trust in general practice

    Skill mix and patient trust in general practice
    Mar 17 2026
    Today, we’re speaking to Dr Charlotte Paddison, who is currently non-executive director at Royal Papworth Hospital, and formerly a Senior Fellow and co-lead for Primary Care at the Nuffield Trust.Title of paper: Implications of skill-mix change in general practice: secondary analysis of data from the GP Patient SurveyAvailable at: https://doi.org/10.3399/BJGP.2025.0360To the authors’ knowledge, no previous studies have investigated the impact on patient trust or perception of needs met when patients are unsure what type of health professional they have seen. Using data from a large national survey, this study found that patients expressed lower confidence and trust, and were less likely to report their needs were met in general practice consultations when they were not sure who their appointment was with. The results are novel in demonstrating that the combination of not knowing who you saw and a remote appointment is particularly problematic for patient trust.TranscriptThis transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions.Speaker A00:00:01.600 - 00:00:58.530Hello and welcome to BJGP Interviews. I'm Nada Khan and I'm one of the Associate editors of the Journal. Thanks for taking the time today to listen to this podcast.In today's episode, we're speaking to Dr. Charlotte Patterson, who is currently non Executive Director at Royal Papworth Hospital and formerly a Senior fellow and co lead for Primary Care at the Nuffield Trust.We're here to discuss the paper she's recently published here in the BJGP titled Implications of Skill Mix Change in General Practice Secondary Analysis of Data from the GP Patient Survey.So, hi, Charlotte, it's really lovely to meet you and to talk about your work and I just really wanted to start by exploring how we know that the composition of the general practice team is evolving with the increasing scope of multidisciplinary work. Really? And I wondered if you could just give us some of the context for this work and what you wanted to do here.Speaker B00:00:58.850 - 00:02:04.870Absolutely. Nada.So what we really wanted to understand was how two big shifts in policy are shaping the experience of patients care when they come to the GP practice. Why do we think that was interesting or potentially important?Basically, we've seen two big changes happening at the same time in the last five years. So.So we've seen the shift to multi professional team working with many more different types of health professionals working in general practice and at the same time, separately, we've seen a massive increase in the number of appointments delivered remotely. So what we wanted to know is what those changes really mean for patients.We also know that some patients feel confused about who they're seeing and when they turn up to a GP appointment at the surgery, whether that's an appointment with a GP or a physician's associate or a social prescriber.And this led on to another really important question for us in this study, which is what happens when patients are confused or uncertain about who they've seen and what does that mean for patient trust? Those are the kinds of questions we wanted to answer.Speaker A00:02:05.350 - 00:02:39.730So this was an analysis of the 2023 GP Patient Survey, which is sent to patients registered in English general practices.And I think the key thing for this work and what you've outlined just in terms of what you're saying right here, was that the survey asks people who their last general practice appointment was with and whether they had confidence and trust in that person and if their needs were met. And just given what you were describing, I wanted to move straight on to what you found.What did the patient say about trust and how did it Vary by different patient characteristics.Speaker B00:02:40.050 - 00:03:27.890Sure. So what we found in relation to trust. Nada.Is that while every 2, 2 in every 3 patients reported they definitely had trust and confidence in the health professional they saw at their GP practice. And that's very positive.We also found at the same time, there's a minority of patients, around 7%, who reported they did not at all have confidence and trust in their last GP practice appointment. And we found that trust is lower among patients who are younger, from minoritised ethnic backgrounds and living in more deprived areas.So that's what we found in relation to trust. We also found that patients are confused about different roles of health professionals working in general practice.And we've found this is likely to affect around one in every 20 patients.Speaker A00:03:28.370 - 00:03:30.290That seems quite a lot, actually, doesn't it?Speaker B00:03:30.530 - 00:04:26.740Yes.And it's also we found, looking at the GP general practice patient survey, we found that the proportion of patients who feel confused about who they're seeing has gone up over time.What I can tell you...
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    19 mins
  • What happens in general practice before an emergency lung cancer diagnosis?

    What happens in general practice before an emergency lung cancer diagnosis?
    Mar 10 2026
    Today, we’re speaking to Marta Berglund, a Research Assistant and PhD candidate at University College London. Title of paper: Pre-diagnostic primary care consultations and imaging in emergency-diagnosed vs referred lung cancer patientsAvailable at: https://doi.org/10.3399/BJGP.2025.0369It has been postulated that emergency diagnoses of cancer (which occurs frequently and confers a poorer prognosis) may relate to suboptimal diagnostic management in primary care, but evidence to support or refute this hypothesis is sparse. We found that emergency-diagnosed patients with lung cancer were less likely to present with relevant respiratory symptoms and had fewer chest imaging investigations before diagnosis compared to patients diagnosed via referred routes, indicating an important role of disease factors in emergency diagnosis.TranscriptThis transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions.Speaker A00:00:01.200 - 00:01:06.690Hello and welcome to BJGP Interviews. I'm Nada Khan and I'm one of the Associate editors of the Journal. Thanks for listening to this podcast today.In today's episode, we're speaking to Marta Bergland. Marta is a research assistant and PhD candidate at university College London.She's recently published a paper here in the BJGP titled Pre Diagnostic Primary Care Consultations and Imaging in Emergency Diagnosed versus Referred Lung Cancer Patients.So, hi, Marta, it's really lovely to meet you and it's great to talk to you about cancer diagnosis, which is a really important area for general practice and also a topic we publish on quite a lot here in the bjgp. It's been fascinating reading this paper and it tackles a cancer that we really don't do well with here in the UK in terms of early diagnosis.But I wonder if you could just start off by telling us a little bit more about lung cancer and how it's actually often diagnosed, which can sometimes lead to some of those poor outcomes.Speaker B00:01:07.010 - 00:02:26.970So, as you said, lung cancer is one of the cancer sites in the UK where the majority or a large proportion of patients are diagnosed through the emergency route, also known as emergency presentations, which is when a patient is diagnosed after they present through an urgent hospital admission or an A and E attendance in the 30 days before diagnosis.And that could look like someone who has had a persistent cough for, say, two weeks, but didn't actually go to their gp, and then suddenly they have a more severe onset of symptoms like shortness of breath, and then they go to A and E and are referred to a chest X ray and then get diagnosed, which is a pathway that is associated with worse prognosis and worse outcomes after diagnosis. And the more preferred route, if you will, in England to diagnose patients is through primary care.So through the GP routine referral or the urgent suspected referral route.And that could look like someone who presents to primary care with cough or dyspneasia again, but then their GP refers them to a chest X ray and then they're diagnosed with lung cancer.Speaker A00:02:27.130 - 00:02:45.290And I guess I wanted to just before we talk about what you found, I wanted to just cover here again, what you mean by this term, that's diagnostic window, because you mentioned that a few times in the paper. But what does this actually mean?And it relates a bit back to some of what you're talking about, about people presenting with symptoms, isn't that right?Speaker B00:02:45.530 - 00:03:09.880So, for us, it's a measure of healthcare use before diagnosis, and it could be any healthcare use Measure like consultations, symptoms, blood test use, anything like that.And it's measuring when that changes compared to baseline before diagnosis, which can signal increased healthcare use associated with the subsequent diagnosis.Speaker A00:03:10.040 - 00:03:16.840Okay, so it just, I guess it's what it says on the tin. It's just that window, isn't it, of potentially being able to pick up a change.Speaker B00:03:17.490 - 00:03:25.970Exactly. So the idea is that if there is an increase long before diagnosis, then possibly there is an opportunity to diagnose these patients earlier.Speaker A00:03:26.450 - 00:04:09.190So this was a really big study using the CPRD and this is a database that a lot of the listeners will be familiar with.And you had a sample of a million patients registered with UK General Practice and then you looked at people diagnosed with cancer and their pre diagnosis rates of consultation like you were talking about, and also chest imaging by the different possible diagnosis routes. So either as an emergency, a routine or an urgent referral. But I really want to move straight to what you found here.Can you give us just an overview of how the different people in this analysis were eventually diagnosed with lung cancer? So were there a lot of emergency diagnoses here?Speaker B00:04:09.350 -...
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    14 mins
  • Designing neighbourhood urgent care: A general practice perspective

    Designing neighbourhood urgent care: A general practice perspective
    Mar 3 2026

    Today, we’re speaking to Dr Mike Holmes, a GP in Yorkshire and Chair of Nimbuscare, a local GP-led multi-neighbourhood provider.

    Title of paper: Neighbourhood delivery of urgent care in North Yorkshire, UK

    Available at: https://bjgp.org/content/76/764/133

    Neighbourhood-based urgent care, led by GP Multineighbourhood providers, can reduce reliance on hospitals and NHS 111. Delivering urgent care in community settings is more cost effective than Urgent Treatment Centre and Emergency Departments attendances. Digital integration and shared clinical systems improve safety, responsiveness, and patient experience. Co-locating operational and clinical teams streamlines service delivery and enables operational and quality oversight. Sustained impact requires recurrent funding and performance measures that reflect system-wide improvement rather than single-provider metrics.
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    24 mins
  • Delayed, declined, or disengaged? Understanding childhood vaccination patterns

    Delayed, declined, or disengaged? Understanding childhood vaccination patterns
    Feb 24 2026
    Today, we’re speaking to Dr Karol Basta, a Public Health Registrar based in London.Title of paper: Predictors of Childhood Vaccination Uptake and Timeliness in a Diverse Urban PopulationAvailable at: https://doi.org/10.3399/BJGP.2025.0319Childhood vaccination rates have declined in the UK, with inequalities in urban, deprived, and ethnically diverse populations. Previous studies have lacked individual-level clinical data or did not explore both uptake and timeliness. We analysed 13 years of routinely collected primary care data for over 37,000 children in a diverse London borough to identify predictors of uptake and timeliness. Distinct sociodemographic and clinical factors were associated with incomplete and delayed vaccination, offering timely insights as responsibility for vaccination services shifts closer to local systems and place-based commissioning.TranscriptThis transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions.Speaker A00:00:00.880 - 00:00:52.000Hi and welcome to BJJP Interviews. I'm Nada Khan and I'm one of the associate editors of the Journal. Thanks for taking the time to listen to this podcast today.In today's episode, we're speaking to Dr. Carol Basta.Carol is a public health registrar based in London and we're here to talk about the paper she's recently published here in the bjgp, which is titled Predictors of Childhood Vaccination Uptake and Timeliness in a Diverse Urban Population. So, hi, Carol, it's really lovely to meet you and to talk about this work. And I guess just to start, I wanted to put this work into context.We know that in the uk, overall childhood vaccination rates have unfortunately been declining. Could you talk us through some of the current challenges around vaccination, especially in urban and diverse areas?Speaker B00:00:52.720 - 00:02:06.750Yep. So we know vaccinations are really powerful and cost effective tools we have in giving children the best start in life life.But unfortunately, in the UK, since 2012, the uptake has been declining and actually since 2021, none of the vaccines in England have reached the 95% target recommended by the WHO to stop communicable disease outbreaks. And the kind of negative consequences of this aren't just sort of future hypothetical risks.We've already been seeing vaccine preventable diseases such as measles and whooping cough resurgences, and this is especially in certain parts of the uk, such as London or the northwest of England. So no uptake of vaccines is decreasing and vaccine preventable diseases are increasing. But that's not the full picture.We also know, for example, following work done by, at the time, Public health England in 2017, there are avoidable inequalities across the childhood vaccination program nationally, for example, linked to deprivation, geography and ethnicity.However, what was missing was really kind of contemporary granular evidence on the social and clinical factors associated with unequal vaccine outcomes, especially in diverse urban environments.Speaker A00:02:06.990 - 00:02:16.670And I know this was highlighted as well during COVID but there is a mistrust of health services amongst some communities as well, which might be playing into this.Speaker B00:02:17.470 - 00:03:11.120Yeah, exactly.So at the time when I was working in Lamb of Council, we knew qualitatively from talking to our community and talking to our local GP partners, that there was kind of sense of rising mistrust in healthcare services, but also rising difficulties with actually access to services.And that doesn't just affect whether or not people can get the vaccine, for example, it also affects whether they can have conversations about vaccines and the kind of continuity of care and building up those relationships.And so this is what we had kind of on a local level, but we knew that there was also national feelings and sentiments around mistrust, not just national, but actually globally vaccination mistrust from the COVID 19 pandemic. And there were worries that this had run off into the childhood vaccination program as well, that it hadn't just confined itself to Covid vaccines.Speaker A00:03:11.440 - 00:03:41.490So this was a study looking at predictors of routine childhood vaccination from 40 general practices in Lambeth and London, which is a pretty ethnically and socioeconomic demographically diverse borough. And you looked here at the vaccination uptake and timeliness and some of the predictors for these. This was a really big sample.But just to underline the population here, tell us more about the demographics in Lambeth as a borough in terms of ethnicity, because that's where you were based when this work was done.Speaker B00:03:41.890 - 00:04:32.250Yeah, exactly.So Lambeth is an inner London borough and it is very ethnically diverse, it's very densely populated, but it also has some of the highest levels of deprivation in the country. And part of ...
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    20 mins
  • From swabs to urine sampling: Rethinking cervical screening in general practice

    From swabs to urine sampling: Rethinking cervical screening in general practice
    Feb 17 2026
    Today, we’re speaking to Prof Emma Crosbie, Professor of Gynaecological Oncology based at the University of Manchester.Title of paper: Urine human papillomavirus testing for cervical screening in a UK general screening population: a diagnostic test accuracy studyAvailable at: https://doi.org/10.3399/BJGP.2025.0105The switch from primary cytology to primary human papillomavirus testing has enabled innovations in self-sampling for cervical screening. This study shows that urine self-collected with a first-void urine collection device has similar diagnostic test accuracy and acceptability to cervical sampling in a general screening population. Urine self-sampling has real-world potential as an alternative cervical screening option.TranscriptThis transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions.Speaker A00:00:01.440 - 00:01:07.140Hello and welcome to BJGP Interviews. I'm Nada Khan and I'm one of the Associate Editors of the bjgp. Thanks for listening to this podcast today.In today's episode, we're speaking to Professor Emma Crosby, who is professor of Gynecological Oncology based at the University of Manchester. We're here to talk about her really exciting paper that's recently been published in the December 2025 issue of the BJGP.The paper is titled Urine Human Papillovirus Testing for Cervical Screening in UK General Screening Population A Diagnostic Test Accuracy Study. So, hi Emma, it's lovely to meet you and to talk about this paper.I really just wanted to start off talking a bit around cervical screening in the uk, and you mentioned this in the introduction to the paper as well, that cervical screening really does have variable uptake rates and we know that there are some, some barriers to access. But can you talk us through these and tell us a bit about why you decided to do this research?Speaker B00:01:07.940 - 00:03:41.440So, as you've just really nicely summarised, cervical screening is really important weapon against cervical cancer.So we know that it prevents cervical cancer and since the introduction of the NHS Cervical Screening program in the UK, we've seen deaths from cervical cancer drop by around 70%. So we know that it's very effective.But in the uk, the number of people attending is declining year on year and currently, currently only around 68% of those people who are eligible for cervical screening actually attend. There are a whole range of different reasons for non attendance.These include things to do with the speculum examination, so having to have an intimate examination to be examined. The anticipated embarrassment or fear of pain related to that procedure, I think are important barriers.But there are also barriers associated with access to reaching screening appointments, taking time off work, having childcare and so on and so forth. So we thought that there was some really important barriers there that could potentially be addressed by self sampling.Now, vaginal self sampling is actually been incorporated in many cervical screening programs around the world.Some cervical screening programs are using it just for people who are non attenders or underscreened by traditional screening routes and other countries are using it as a choice for everybody.Now, in the uk, we haven't yet taken up vaginal self sampling sampling, but it will be introduced this year in 2026, principally for under screened groups. And there is some work looking at whether or not it will be introduced as a choice for everyone in the future.But we know from research that's been done in the UK that only around 12 to 13% of people who are offered vaginal self sampling who are under screened actually return a sample. And therefore it clearly doesn't address all the barriers to cervical screening. And we wondered whether a urine test would have more app.It would have the same benefits of vaginal self sampling in that it can be collected at home and posted to the laboratory. So it removes that need for an intimate examination.It removes the need for, you know, making an appointment at a healthcare facility to have your screen taken, but it perhaps, you know, removes some of the barriers towards putting a swab inside the vagina that might be culturally or religiously unacceptable to some groups. And so we thought that a urine self sample could be another option for people who currently aren't screened.And so we wanted to see how accurate it was in this study.Speaker A00:03:42.320 - 00:04:03.760And those issues around access are really important, especially in this population of women who are juggling lots of caring responsibilities with young children or caring for older relatives as well.So sometimes it is just difficult to get to an appointment and, you know, juggling work hours and things which often then coincide with GP opening hours as well.Speaker B00:04:03.920 - 00:04:41.960Yeah, absolutely.And we, we have seen a drop in people, you...
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    16 mins
  • Trust matters: A practice-level look at patient confidence in health professionals

    Trust matters: A practice-level look at patient confidence in health professionals
    Feb 10 2026
    Today, we’re speaking to Professor Richard Baker, emeritus Professor at the University of Leicester. Title of paper: Factors influencing confidence and trust in health professionals: a cross-sectional study of English general practices.Available at: https://doi.org/10.3399/BJGP.2025.0154A transactional model of general practice is being introduced to improve access that involves triage and increasing percentages of appointments with professionals other than GPs or that are not face-to-face. Using summary data about almost all English general practices in 2023-24 with 750 or more patients, the patient-reported levels of confidence and trust from the General Practice Patient Survey were associated with increased percentages of appointments that were with GPs or were face-to-face, and with higher continuity, after adjusting for other practice and patient factors. Confidence and trust was lower in practices with fewer appointments per year per patient, fewer patients having their needs met, greater deprivation, fewer patients of White ethnicity, and in practices located in London, as compared to other regions of England. Access to general practice needs improving, but the findings of this cross-sectional study suggest that preserving features of relationship-based care is also needed to maintain patients’ trust and confidence in health professionals.TranscriptThis transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions.Speaker A00:00:01.200 - 00:00:46.980Hello and welcome to BJGP Interviews. I'm Nada Khan and I'm one of the Associate editors of the Journal. Thanks for joining us here to listen to this podcast today.In today's episode, we're speaking to Professor Richard Baker, Emeritus professor at the University of Leicester. We're here to talk about the paper that he and his colleagues have recently published here in the bjjp.The paper is titled Factors Influencing Confidence and Trust in Healthcare A Cross Sectional Study of English General Practices. So, hi, Richard, thanks for joining me here today and it's nice to see you again.Just before we talk about this paper, I wonder if you could just talk to me about trust and why you think it's important in general practice interactions.Speaker B00:00:47.780 - 00:01:32.060Well, it's difficult to have a consultation with a patient if they don't trust you. I mean, it's just very basic, a very basic level, very simple level. But there's lots of evidence as well that trust is important.People who trust you are more likely to follow your advice. They're more likely to take the medication.They're more likely therefore, to come back and see you again, more likely to use services appropriately in the future. And there's some evidence that the outcomes are better if there's trust there. Trust obviously should be earned.You can't take it for granted, you've got to be trustable. But it's obviously very important for clinical practice and essentially always has been, hasn't it, really? Going back to the.The Greek doctors, trust was important then, just as it is now.Speaker A00:01:32.460 - 00:01:38.540And you mentioned about different outcomes. So what sort of outcomes do we know could be associated with trust?Speaker B00:01:39.180 - 00:02:07.990Just use of services is one example.So you can get people who, if they don't trust who they see, they go and see someone else and again, and so they overuse services and that waste resources.On the other hand, you may get people who just won't come, so they'll delay presenting with the problems because they don't trust the provider to get it right. Then they risk of poor outcomes as a consequence of that. So it's a whole mixture of things.Speaker A00:02:09.030 - 00:02:21.190So what were you trying to do in the study?So you wanted to look at trust and how it impacted on patient outcomes, or was it more about sort of the predictors and associations with trust, isn't it?Speaker B00:02:21.800 - 00:04:33.330Yes, I think we were conscious that general practice has gone through a lot of change.The big changes came about during the pandemic as to how general practice is delivered, how people have their appointments and things have sort of Reverted a bit to how they were, but only partially in terms of who you get to see face to face, appointment and so on. And we were asking the question, well, what has been the consequence of this?Should we be thinking about confidence and trust in association with these changes?I mean, the changes may have been absolutely essential because we just don't have the capacity in general practice to do everything that we would like to do for an increasingly multi morbid population. But what are the consequences? How do we need to respond? How do we need to respond?Questions I guess for follow on from Is there a link between confidence and trust and these changes in general practice changes?I think when we looked at this, we've sort of ...
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    17 mins