Scottish Patient Experience Survey of GP and Local NHS Services 2011/12 Volume 3: Variation in the Experiences of Primary Care Patients

5 Detailed Findings - Ethnicity

5.1 Patients were asked to indicate their ethnic group. The answer options were White; Mixed or Multiple; Asian, Asian Scottish or Asian British; African, Caribbean or Black; or Other ethnic group. Patients were asked to select from one of the five categories. For the analysis, each group was compared with White people, the largest group.

5.2 The ethnicity of the respondents is shown in Table 3.

Table 3 Ethnicity of respondents

5.3 Of the 39 questions modelled, ethnicity had an effect on experiences for 19 of them. However the effects of ethnicity on experiences were generally quite weak.

5.4 Where there were some differences this tended to be in Asian, Asian Scottish or Asian British group and other ethnic groups; these groups tended to report less positive experiences. African, Caribbean or Black groups reported a similar experience to White patients. This finding is in consistent with the recent analysis of the English GP survey (Lyratzopoulos et al 2012) which found that Asian and Chinese patients were more negative than White patients while Black/White patient differences were small and inconsistent.

5.5 While the differences we found were generally weak, it's difficult to explain any difference and in particular why particular ethnic groups tended to report a more negative experience. A number of possibilities have been suggested in the literature. One possibility is that there are differences in expectation of care with some ethnic minority groups having higher expectations of quality (Mead and Roland 2009). Lyratzopoulos et al 2012 suggest that another possibility for some ethnic groups is linguistic proficiency. Most UK Black patients who report similar experiences to White patients are descendants of immigrants from English speaking counties, while this is not necessarily the case for people with Asian background who are more negative. The authors suggest that in some cases linguistic proficiency may not mean that patients are receiving worse care but rather it may affect how survey questions are understood by people. However the authors draw on other research to suggest that linguistic proficiency may mean that some patients actually receive worse care due to access and communication difficulties as well as discrimination unintended or otherwise.