Patients said standards had slipped

YouGov found patients feel changes in GPs' work, like opting out of 24-hour duties, have lowered standards of care.

More than a quarter of group practice patients said the doctor who saw them had no idea about their medical history.

But the British Medical Association said GPs were committed to providing holistic care.

The changes

The new GP contract, which came into effect in April, means patients are the responsibility of the entire practice rather than an individual GP within the practice.

Under the contract, all GPs will be able to opt out of working nights and weekends - and the British Medical Association estimates around 90% of GP practices will do so.

But about 50% of GPs will continue to do out of hours work on an individual basis, it estimates.

Primary Care Trusts will take over responsibility for providing the care.

Many patients were uneasy about these changes, according to the poll of 2,424 patients which was carried out for the Daily Telegraph.

Patients in group practices were far more unhappy with standards of care than those with their own GP, particularly those living in cities like London, Birmingham and Glasgow.

Most practices will ask a patient if they want to see a particular doctor Dr Hamish Meldrum, chairman of the BMA's GP's committee

A fifth said standards had deteriorated in recent years, compared with a tenth of those who had their own doctor.

Only a third thought group practice doctors they saw knew who they were.

Although 59% thought it was good that doctors should not be on call around the clock, about a third thought a local doctor should be available night and day.

Only 8% said they would be willing to pay to see a doctor of their choice.

But chairman of the British Medical Association's GP's committee, Dr Hamish Meldrum, does not believe the changes to GPs work will be significant for patients.

"We know the patients like to get to know their doctors and feel they can trust them.

"Most practices will ask a patient if they want to see a particular doctor."

Quality care

He said it was about providing the best care, which is a balance quality and quantity of care.

"Twenty years ago a patient would apologise for calling a doctor out of hours. Today they expect the doctor to be fresh. They are not prepared to make allowances," he said.

A Department of Health spokesman said: "The new GP contract will bring better care to patients as doctors are rewarded for the quality of care they provide.

"These new working arrangements were introduced to reduce pressure in GP's working lives. This extra flexibility will ultimately make General Practice more attractive to younger doctors, bringing more GPs into the local community.

"The new contract is practice-based, but patients will still have a named-GP for their care. It is for practices to organise themselves to deliver the best possible care for their patients."

Paul Burstow MP, Liberal Democrat Shadow Health Secretary, said: "This report shows that what patients really want is access to quality health care on their doorstep.

"Instead of chasing around after political targets, doctors should be allowed to focus on providing proper care to their individual patients.

"The new GP contract was the end of the one stop shop for local health care. Patients will now inevitably go to different places for different types of care.

"It is essential that local health trusts and GPs make the most of the changes to the system to provide easier access to good quality care for all patients," he said.

The Royal College of GPs' honorary secretary, Maureen Baker, said: "This survey, and others like it, show that the vast majority of patients are more than happy with the service they recieve from their GP.