Variations between primary care trusts in the quality of their GP services and how easily patients can access them remain stark.

A decade ago, NHS Primary Care Commissioning’s first study into quality, access and cost in GP services found an almost threefold difference around the country in access to GP appointments with a female doctor.

We hope patients will vote with their feet

Its latest research suggests that gap has widened in places. Across England there are 1.9 male full time equivalent GPs for every one female, but in one PCT there are 6.7 male for every one female GP and in 5 per cent of PCTs male GPs outnumber females by three to one or more. Only one PCT has more female GPs than male.

The PCT with the lowest number of female GPs also reported the lowest rate of patient satisfaction when measured on patients’ ability to book an appointment with a specific GP. The average practice score for that PCT in 2007-08 was just 46 per cent, compared with a national average of 87 per cent. The highest performing PCT scored 100 per cent.

Westminster PCT chief executive Michael Scott said that although it may have previously been true to say PCTs had ignored the value for money they were getting from their primary care contracts “that was changing rapidly”.

He said the “scope for change is limited” due to the restrictions in the national contract but his PCT was now publishing a scorecard on each of its practices, revealing their performance on quality and access.

He said: “We have variations in performance and in making that public we hope patients will vote with their feet.”

PCTs neglect value in general practice