Distribution and quality of private GP practices in England: a cross-sectional analysis.

Background: Public surveys have indicated increasing demand for private GP services amidst difficulty in accessing NHS GP services. However, little is known regarding the location and quality of private GP practices.

Aim: To examine the distribution of private GP practices in England, their relationship with NHS GP practices and comparative quality measures.

Method: We identified all private GP practices registered with the Care Quality Commission (CQC) in England, as of April 2024. We used negative binomial regression to analyse the number of private GP practices within 10 km of NHS GP practices and patient reported access and continuity as well as the market environment and practice characteristics. We used ordinal logistic regression to compare quality ratings between all private and NHS GP practices.

Results: Characteristics associated with the count of nearby private GP practices included average population income (IRR 1.07, 95% CI = 1.06 to 1.08), patient satisfaction with NHS appointment wait (IRR 1.10, 95% CI = 1.07 to 1.13) and continuity (IRR 0.96, 95% CI= 0.94 to 0.98), proportion of community from ethnic minority (IRR 1.11, 95% CI = 1.08 to 1.14), NHS GPs per 10 000 patients (IRR 1.02, 95% CI = 1.01 to 1.04), community deprivation (IRR 0.90, 95% CI = 0.88 to 0.92) and urban location (IRR 2.15, 95% CI = 1.71 to 2.69). Quality ratings were similar between private and NHS GPs.

Conclusion: Private GP services are more common in more affluent areas with greater supply of and access to NHS GPs. This may exacerbate inequalities in access to GP services between richer and poorer areas, when considering access to both NHS and private GP services.