Distribution and quality of privately-funded general practices in England: a cross-sectional analysis

Background Public surveys indicate demand for privately-funded general practice services in England has increased. However, little is known regarding the number, location and quality of private general practices.

Aim To examine: 1) the geographical distribution of private general practices across England; 2) the relationships between access, continuity of care and funding of NHS general practices with nearby private practices; and 3) the quality ratings of NHS and private general practices.

Design & setting Cross-sectional analysis of NHS and private general practices in England as of April 2024.

Method We used the Care Quality Commission (CQC) Primary Medical Services Inspectorate to identify all private general practices in England. We used multilevel logistic regression to examine associations between NHS practice characteristics and the presence of a private general practice nearby. We then compared available CQC ratings.

Results As of April 2024, England had 358 private and 5,976 NHS practices. Private general practices are primarily in London and other urban areas. NHS practices with higher patient satisfaction with waits for appointments (odds ratio 1.08 (95% CI: 1.03–1.13)) and more GPs per 10,000 patients (1.04 (1.01–1.06)) were more likely to have a private practice nearby. There was no association with continuity of care or funding. Quality ratings were similar, although 44% of private practices were unrated by the CQC.

Conclusion Private general practices are more common in London, as well as areas with better access to NHS GPs. The growth in private general practices may have widened inequalities in access to primary care.