Published: 29/07/2004, Volume II4, No. 5916 Page 20

Angela Coulter's letter, labelling MORI's analysis of national patient surveys as misleading, completely misses the point (Feedback, page 20, 15 July).

She criticises our use of overall patient ratings as a measure of hospital performance for being too simplistic.However, if Ms Coulter had read the report on which our article was based she would have seen that we have indeed examined all aspects of care in the patient survey, not just one question, in reaching our conclusions.

Our analysis of perceptions of primary care trusts was based on an aggregate analysis of all the key dimensions of care contained in the survey.

Overall perceptions are very closely linked to a range of quite specific aspects of the care they receive - including whether they were treated with dignity and respect, cleanliness of wards/toilets, the help they were given to control their pain, whether or not side effects were communicated properly and the privacy they were given when discussing treatments.

This demonstrates the things that hospitals need to focus on to make the patient experience more positive.

Answering the second criticism raised by Ms Coulter, our report sets out quite clearly that we are by no means condoning poor performance.

Quite the reverse.While we highlight a number of trusts that are doing much better than might be expected given the nature of the population they serve and the resources available, our report points out that this does not mean we should not expect and demand improvement. It simply means there are no other trusts in similar situations which are, at present, doing better.

The bottom line is that while not condoning it, it is more difficult to achieve the very highest absolute patient ratings in some communities than in others, and our report highlights the challenge ahead in showing patients and voters that investment is making a difference - everywhere.

Ben Page Director MORI Social Research Institute We support the work being done by MORI in trying to gain a better understanding of the key factors that influence patients' perceptions of the NHS (Ideas, pages 16-18, 1 July).

However, we question MORI's use of highly selective, secondary data to construct a hypothesis that correlates 'demanding' populations (defined by MORI as culturally diverse and young people) and resources (such as the number of GPs per head of population) to provide a measure of an NHS trust's 'efficiency'.

We also feel strongly (given the local press interest we have encountered over the article) that MORI's Ben Page should have subjected his data to the same rigour that the Healthcare Commission uses in determining its performance ratings, and certainly before putting MORI's own 'league' table in the public domain.Had he done so, we would have pointed out that his GP figures for Oxford City primary care trust are incorrect.

We have 69 and not 88 GPs per 100,000 population.

We would have pointed out that we dispute the 2001 census data that deems us to have a population of 157,000 patients, when we currently provide care to 198,000 patients registered with our Oxford city GPs. As in other inner-city areas with a large student and ethnic population, the census population figures are currently the subject of appeal by both Oxford city and Oxfordshire county councils.

These changes in data would tell a very different story about Oxford City PCT's apparent 'efficiency' highlighted in Ben Page's article.

Andrea Young Chief executive Oxford City PCT