Patients’ evaluations of patient safety in English general practices: a cross-sectional study

Background: Previous studies on the frequency and nature of safety problems and harm in general practices are based on information supplied by health professionals, and scarce attention has been paid to patients themselves.
Aim: To examine patients´ perceptions and experiences of patient safety in Primary Care in England.
Design and Setting: Cross-sectional study in 45 general practices.
Method: The Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) postal questionnaire was sent to a random sample of 6,736 patients. Main outcome measures included “practice activation” (what does the practice do to create a safe environment); “patient activation” (how pro-active are patients in ensuring safer healthcare); “patients’ experiences of safety events” (errors); “outcomes of safety” (harm); and “patient’s overall perception of safety” (how safe do patients think their practice is).
Results: 1,244 patients (18.4%) returned completed questionnaires. Scores were high for “practice activation” (mean (standard error) = 80.4 out of 100 (2.0)) and low for “patient activation” (26.3 out of 100 (2.6)). A substantial proportion of patients (45%) reported having experienced at least one safety problem in the previous 12 months, mostly related to appointments (33%), diagnosis (17%), patient-provider communication (15%), and coordination between providers (11%). 221 patients (23%) reported having been harmed in the previous 12 months. The overall assessment of the level of safety of their practices was generally positive (86.0 out of 100 (16.8)).
Conclusion: This study helped to identify priority areas for patient safety improvement in general practices in England: appointments, diagnosis, communication and coordination.