General Practice Services Research Articles

General practice consultations and use of prescription drugs after changes to school absence policy.

New rules for absence with stricter requirements for documentation were introduced in upper secondary schools in the autumn of 2016. We investigated the use of general practice services and dispensing of prescription drugs among 16 – 18-year-olds in the autumn of 2016 and compared this with equivalent figures for the period 2013 – 15. We retrieved information on consultations in general practice (GP) and dispensing of prescription drugs to 15 – 18-year-olds in the period 2013 – 16 from the Directorate of Health’s system for control and payment of health reimbursements (KUHR) and the Norwegian Prescription Database respectively. The number of consultations and dispensing of drugs were compared to previous years using Poisson regression (reference year 2015). The incidence rate ratio (IRR) was used as an outcome measure. The number of GP consultations for 16 – 18-year-olds was 30 % higher in the autumn of 2016 than in the autumn of 2015 (IRR 1.30, 95 % confidence interval (CI) 1.29 – 1.31). In the same period, the dispensing of drugs to this age group increased by 8 % (IRR 1.08, 95 % CI 1.08 – 1.09). Among the diagnosis groups, respiratory tract infections had the largest increase (IRR 2.21, 95 % CI 2.17 – 2.25). The largest increase in drug dispensing was found for remedies for coughs and colds (IRR 1.73, 95 % CI 1.65 – 1.80). The increase in consultations in general practice and dispensing of drugs to 16 – 18-year-olds coincided in time with the introduction of new rules for absence from school. We hold it to be highly likely that the changes were caused by the stricter rules for documentation of absence from school.

Factors affecting young people's preferences for emerging technologies for chlamydia testing and treatment: a discrete choice experiment in England

BackgroundTechnological advances offer opportunities to redesign existing chlamydia screening and testing, and treatment pathways, to improve screening uptake and the proportion of positive individuals successfully treated. Innovations underway include self-tests networked through mobile phones, which could be combined with online clinical care and other non-face-to-face care pathways. Evidence of young people's preferences should be key to informing optimum service redesign. We aimed to quantify factors affecting young people's preferences for emerging chlamydia testing and treatment pathway options in a discrete choice experiment (DCE). MethodsMethods used to select attributes and levels for the DCE included a systematic literature review, four focus groups (staged recruitment to include spread in age range 16–24 years and other demographic characteristics), and four expert groups of clinicians and researchers. The literature review sought stated preference studies for testing and treatment of sexually transmitted infections (STI) published before Dec 31, 2015. Studies were published in English, and included one or more aspects of mainstream STI testing and treatment for any STI, undertaken in an Organisation for Economic Co-operation and Development high-income country. Key search terms included stated preference, stated choice, DCE, contingent valuation, and conjoint analysis. A draft questionnaire was tested in a pilot (n=9). The final questionnaire (including 25 pairwise choices with opt-out) was completed online by a national panel of young people aged 16–24 years across England (YouthSight). Analysis used multinomial logit models and included validity checks. FindingsThere were 1230 respondents (response rate 73%). The strongest attribute affecting preferences was chlamydia test accuracy (odds ratio [OR] 3·24, 95% CI 3·13–3·36), followed by time to result (1·81, 1·71–1·91). Respondents showed a preference for remote chlamydia testing options (self-testing, self-sampling, postal testing) over attendance at a testing location. A general preference for accessing treatment was observed for online (OR 1·21, 95% CI 1·15–1·28) versus traditional general practice (1·18, 1·12–1·24), pharmacy (1·15, 1·10–1·22), or clinic (OR 1) services. Little difference was observed between face-to-face, telephone, instant messaging or email methods of access. No significant difference in preferences was seen for antibiotic provision (eg, collection from pharmacy vs postal delivery). InterpretationDCE coefficients can help estimate uptake probabilities for redesigned chlamydia pathways. Although this DCE was conducted in an online population, which might limit generalisabiity to other populations, findings could assist technology developers, policy makers, commissioners, and service providers to optimise the adoption of emerging technologies and service redesign. FundingThe doctoral fellowship of SE is supported by the Medical Research Council under the UK Clinical Research Collaboration Translational Infection Research Initiative (grant G0901608).

P.4.d.007 - Cognitive behavioural therapy enhances compensatory neural circuitry in obsessive compulsive disorder

Cognitive-behavioral therapy (CBT), which encompasses exposure with response prevention (ERP) and cognitive therapy (CT), has demonstrated efficacy in the treatment of obsessive–compulsive disorder (OCD). However, the samples studied (reflecting the heterogeneity of OCD), the interventions examined (reflecting the heterogeneity of CBT), and the definitions of treatment response vary considerably across studies. This review examined the meta-analyses conducted on ERP and cognitive therapy (CT) for OCD. Also examined was the available research on long-term outcome associated with ERP and CT. The available research indicates that ERP is the first line evidence based psychotherapeutic treatment for OCD and that concurrent administration of cognitive therapy that targets specific symptom-related difficulties characteristic of OCD may improve tolerance of distress, symptom-related dysfunctional beliefs, adherence to treatment, and reduce drop out. Recommendations are provided for treatment delivery for OCD in general practice and other service delivery settings. The literature suggests that ERP and CT may be delivered in a wide range of clinical settings. Although the data are not extensive, the available research suggests that treatment gains following ERP are durable. Suggestions for future research to refine therapeutic outcome are also considered.

Demographic characteristics of survivors of torture presenting for treatment to a national centre for survivors of torture in Ireland (2001-2012).

The asylum process has received a lot of recent media attention but little has been said about the psychological needs of those seeking or granted asylum. Many asylum seekers have experienced trauma and torture, which is associated with substantial psychiatric and psychological morbidity. The Spiritan Asylum Services Initiative (Spirasi) is Ireland's national treatment centre for survivors of torture. The aim of this study was to examine the demographic profile of those attending Spirasi and to consider potential clinical implications of this. We retrospectively analysed demographic data relating to the 2590 individuals who attended Spirasi over a 12-year period (2001-2012 inclusive). The majority of attenders were asylum seekers (88%), male (71%) and from African countries. The mean age was 31.9 years. The rate of new referrals, as a percentage of Ireland's asylum-seeking population, has stabilised at ~6% since 2008. Women are underrepresented among those who attend. The number of new referrals to Spirasi is lower than expected given international estimates of torture prevalence and the impact this has on mental health. Clinicians working with populations of asylum seekers and refugees should sensitively enquire about such events and be aware of the available services. Female refugees and asylum seekers are underrepresented, especially from Asian and Middle Eastern regions. Psychiatric, psychological and general practice services need to respond flexibly to evolving patterns of migration and address potential barriers to access, especially among female refugees and asylum seekers.

What are GPs' preferences for financial and non-financial incentives in cancer screening? Evidence for breast, cervical, and colorectal cancers

General practitioners (GPs) play a key role in the delivery of preventive and screening services for breast, cervical, and colorectal cancers. In practice, GPs' involvement varies considerably across types of cancer and among GPs, raising important questions about the determinants of GPs' implication in screening activities: what is the relative impact of financial and non-financial incentives? Are GPs' preferences for financial and non-financial incentives cancer-specific? Is there preference heterogeneity and how much does it differ according to the screening context? This study investigates the determinants of GPs' involvement in cancer screening activities using the discrete choice experiment (DCE) methodology. A representative sample of 402 GPs' was recruited in France between March and April 2014. Marginal rates of substitution were used to compare GPs' preferences for being involved in screening activities across three types of cancers: breast, cervical, and colorectal. Variability of preferences was investigated using Hierarchical Bayes mixed logit models. The results indicate that GPs are sensitive to both financial and non-financial incentives, such as a compensated training and systematic transmission of information about screened patients, aimed to facilitate communication between doctors and patients. There is also evidence that the level and variability of preferences differ across screening contexts, although the variations are not statistically significant on average. GPs appear to be relatively more sensitive to financial incentives for being involved in colorectal cancer screening, whereas they have higher and more heterogeneous preferences for non-financial incentives in breast and cervical cancers. Our study provides new findings for policymakers interested in prioritizing levers to increase the supply of cancer screening services in general practice.

Moving into the ‘patient-centred medical home’: reforming Australian general practice

The Australian healthcare system is a complex network of services and providers funded and administered by federal, state and territory governments, supplemented by private health insurance and patient contributions. The broad geographical range, complexity and increasing demand within the Australian healthcare sector mean health expenditure is high. Aspects of current funding for the healthcare system have attracted criticism from medical practitioners, patients, representative organisations and independent statutory agencies. In response to the problems in primary care funding in Australia, The Royal Australian College of General Practitioners developed the Vision for general practice and a sustainable healthcare system (the Vision). The Vision presents a plan to improve healthcare delivery in Australia through greater quality, access and efficiency by reorienting how general practice services are funded based on the ‘patient-centred medical home’ model.

Access to general practice in England: political, theoretical, and empirical considerations.

Access to general practice services in England has been a prominent theme in recent issues of the BJGP . Simpson and colleagues1 outlined the historical context of current policy to extend practice opening hours in the evenings and at weekends. Campbell and Salisbury2 examined the conceptual foundations of access to health care. Ford and colleagues3 reported empirical work on patient preferences for additional opening hours, while Scantlebury and colleagues4 modelled general-practice-level determinants of emergency department visits. We extend this discussion below, focusing on the UK government’s controversial commitment for all patients in England to be offered GP appointments between 8 am and 8 pm, 7 days a week, by 2020.5 Language used by the government when referring to its commitment to extend opening hours, in addition to that used for its wider political strategy, provides one means of analysing this policy. Relevant government press releases often refer to people with busy work and family lives who struggle to fit in GP appointments; the latest mentioned ‘7-day GP services for hardworking families’ and offering ‘hardworking taxpayers and families the security of care they need’ .6 In April 2015, at the launch of the Conservative Party manifesto for the last UK general election, David Cameron declared the Conservatives to be ‘the party of working people’ .7 In October 2015, after being re-elected as Prime Minister, he repeated this position at the Conservative Party conference: ‘The party of working people, the party for working people — today, tomorrow, always.’ 8 The consistent rhetoric, highlighting a focus on the employed, is one sign that the policy to extend opening hours cannot be divorced from wider political activity. The timing, source, and place of the government’s statements on this policy issue are also revealing. The Prime Minister, rather …

Mapping access to health services as a strategy for planning: access to primary care for older people in regional Queensland.

Australia has seen a significant increase in people aged over 65 years accessing general practice services over the last decade. Although people aged 65 years and over comprise 14% of the total population, this age demographic accounts for the largest proportion of general practitioner (GP)-patient encounters. Access to general practice is important for older Australians as the burden of chronic disease increases with age. A geographic information system, ArcGIS, was used to assess geographic access to general practice for older people residing in the regional Queensland towns of Mackay, Townsville and Cairns. Geographic units with high proportions of over 65-year-old people were spatially analysed in relation to proximity to geomapped general practices with a 2-km buffer zone. Modelling of changes in access was performed with the strategic location of a new general practice where gaps existed. Geographic access to general practice for the older population was poorest in Cairns despite a high population density. Addition of a single, strategically placed general practice in Cairns markedly improved access. Socioeconomic analysis suggested that general practices were appropriately located in areas of greatest need. Geographic information systems provide a means to map population characteristics against service locations to assist in strategic development and location of future health services.

Acceptability of general practice services for Afghan refugees in south-eastern Melbourne.

Over 750000 refugees have resettled in Australia since 1945. Despite complex health needs related to prior traumatic experiences and the challenges of resettlement in a foreign country, refugees experience poor access to primary care. Health and settlement service providers describe numerous cultural, communication, financial and health literacy barriers. This study aimed to investigate the acceptability of general practitioner (GP) services and understand what aspects of acceptability are relevant for Afghan refugees in south-eastern Melbourne. Semi-structured interviews were conducted with two Afghan community leaders and 16 Dari- or English-speaking Afghan refugees who accessed GP services. Two distinct narratives emerged - those of recently arrived refugees and established refugees (living in Australia for 3 years or longer). Transecting these narratives, participants indicated the importance of: (1) a preference for detailed clinical assessments, diagnostic investigations and the provision of prescriptions at the first consultation; (2) 'refugee-friendly' staff; and (3) integrated, 'one-stop-shop' GP clinic features. The value of acceptable personal characteristics evolved over time - GP acceptability was less a consideration for recently arrived, compared with more, established refugees. The findings reinforce the importance of tailoring healthcare delivery to the evolving needs and healthcare expectations of newly arrived and established refugees respectively.

Maternal health inequalities and GP provision: investigating variation in consultation rates for women in the Born in Bradford cohort.

The 'Five Year Forward View' (NHS England) calls for a radical upgrade in public health provision. Inequalities in maternal health may perpetuate general patterns of health inequalities across generations; therefore equitable access to general practice (GP) provision during maternity is important. This paper explores variation in GP consultation rates for disadvantaged mothers. Data from the Born in Bradford cohort (around 12000 women), combined with GP records and GP practice variables, were modelled to predict GP consultation rates, before and after adjusting for individual health and GP provision. Observed GP consultation rates are higher for women in materially deprived neighbourhoods and Pakistani women. However these groups were found to consult less often after controlling for individual health. This difference, around one appointment per year, is 'explained' by the nature of GP provision. Women in practices with a low GP to patient ratio had around 09 fewer consultations over the six year period compared to women in practices with the highest ratio. Equitable access to GP services, particularly for women during the maternal period, is essential for tackling deep-rooted health inequalities. Future GP funding should take account of neighbourhood material deprivation to focus resources on areas of the greatest need.

Emergency hospital admissions for asthma and access to primary care: cross-sectional analysis.

Access to general practices may be an important determinant of emergency admissions for asthma, as early treatment of exacerbations has been shown to prevent deterioration. To determine whether access to primary care is associated with emergency admissions for asthma. Cross-sectional analysis of data from English practices in 2010-2011. Negative binomial regression was used to explore the associations between emergency admissions for asthma and seven measures of patient-reported access to general practice services taken from the GP Patient Survey, controlled for the characteristics of practice populations. Incidence rate ratios (IRR) were calculated for each association. In total 7806 (95%) of practices had data for all variables. There were 3 134 106 patients with asthma, and there were 55 570 emergency admissions with asthma. Admission rates were lower in practices with a higher composite access score (adjusted IRR for 10% change in variable 0.679, 95% CI = 0.665 to 0.708). Admissions were higher in those practices with higher proportions of the practice population who were white, and in practices with lower performance in the Quality and Outcomes Framework indicator 'asthma review in past 15 months' (Asthma 6). Assuming these associations were causal, a higher access score of 10% was associated with a decrease of 17 837 admissions per year for these practices. Practices with higher patient-reported access had lower rates of emergency admissions for asthma. Policymakers should consider improving access to primary care as one potential way to help prevent emergency hospital admissions for asthma.

NH4 Service development for people with HIV who have comorbid conditions using experience-based co-design methodology

Background/introduction There is a need for evidence - based models of care to effectively manage the increasing numbers of the people with HIV (PWH) who have comorbid conditions. This study was part of an NIHR Programme Development Grant to inform the development of HIV services to meet the needs of an ageing population. Aim(s)/objectives To explore the healthcare experiences of PWH who have comorbid conditions and the staff involved in their care to identify priorities for service improvement. Methods Experience-based co-design methodology was used to understand the experiences of PWH accessing General Practice, HIV, Cardiology, Liver, Renal and Rheumatology services. Patients were recruited from the HIV clinic and staff purposively sampled from the service areas. Experiences were gathered through observation, diaries, audio and filmed interviews. Thematic analysis was undertaken and filmed patient interviews analysed for emotional touchpoints. Staff and patient feedback events were utilised to validate data and identify areas for service development. A joint staff and patient co-design event was held to agree shared priorities for future services. Results 22 patients (with 110 comorbidities) and 18 staff were recruited. A composite film was produced from the patient interviews. Examples of touchpoints were communication, burden of appointments and repetition across services. Patients identified 6 areas for service improvement and staff identified 3. The agreed priorities for future service development were care co-ordination, shared medical records/results and systems to manage multiple appointments. Discussion/conclusion Experience-based co-design methodology was effective in identifying future service models for PWH who have comorbid conditions.

Patterns and predictors of help-seeking contacts with health services and general practitioner detection of suicidality prior to suicide: a cohort analysis of suicides occurring over a two-year period

BackgroundContact with primary care and psychiatric services prior to suicide may be considerable, presenting opportunities for intervention. However, there is scant knowledge on the frequency, nature and determinants of contact.MethodRetrospective cohort study-an analysis of deaths recorded as suicide by the Northern Ireland Coroner’s Office linked with data from General Practice patient records over a 2 year periodResultsEighty-seven per cent of suicides were in contact with General Practice services in the 12 months before suicide. The frequency of contact with services was considerable, particularly among patients with a common mental disorder or substance misuse problems. A diagnosis of psychiatric problems was absent in 40 % of suicides. Excluding suicide attempts, the main predictors of a noted general practitioner concern for patient suicidality are male gender, frequency of consultations, diagnosis of mental illness and substance misuse.ConclusionsDespite widespread and frequent contact, a substantial proportion of suicidal people were undiagnosed and untreated for mental health problems. General Practitioner alertness to suicidality may be too narrowly focused.

Use of general practice services 5 years after an episode of mental illness: case-control study using electronic records.

Depression, anxiety, and emotional distress occur frequently and are usually treated in general practice. Little has been reported about the long-term course of these conditions and the long-term use of medical services. To follow up patients with depression, anxiety, and emotional distress in general practice for 5 years and examine the length and number of index episodes, prescribing behaviour, and the use of services in general practice. A case-control study using data from electronic medical records. Three cohorts of patients with depression (n = 453), anxiety (n = 442), and emotional distress (n = 185) were compared against a cohort of control patients (n = 4156) during a 5-year follow-up from 2007 to 2011. The occurrence or recurrence of the index disorders, other psychological disorders or medical conditions, the numbers of prescriptions, and the number of contacts with the general practice were all examined. Patients in the depression group had 1.1 followup episodes of depression, those in the anxiety group had 0.9 follow-up episodes of anxiety, and those in the emotional distress group had 0.5 follow-up episodes of emotional distress during the 5 years. All three groups had more consultations (for both psychological and somatic reasons) during each of the follow-up years than control patients. Furthermore, the groups with mental health disorders were given more prescriptions for psychopharmacological treatment. Five years after the index episode in 2007, patients with an episode of depression, anxiety, or emotional distress are still not comparable with control patients, in terms of the prevalence of mental health conditions, the number of prescriptions, and healthcare use.

Care of patients with cancer pain in general practices in Germany

In line with the increased life expectancy of people in Germany, the probability of falling ill with amalignant disease is continuously increasing. About 480,000 people in Germany contract cancer every year. One of the most important symptoms of amalignant disease is pain. Between 40 and 100% of patients with advanced cancer suffer from pain. The aim of this investigation is to show how German general practitioners care for these patients using analgetics. The data were extracted from the CONTENT database (CONTinuous morbidity registration Epidemiologic NeTwork) of the Department of General Practice and Health Services Research at the University Hospital in Heidelberg. This database has data from more than 200,000 patients and more than 3million physician/patient contacts. The prescriptions were classified using the ATC code. Patients experiencing pain from cancer received all kinds of analgetic drugs. The data comprises 9752 prescriptions for 1362 patients. There were 4975 (51.1 %) prescriptions for Class1 analgesics, 929 (9.5 %) for Class2 analgetics and 1918 (19.7 %) prescriptions for Class3 analgetics. Coanalgetics were prescribed 1930 (19.7 %) times. 1,167 patients (85.7 %) were treated in the correct manner according to the guidelines of the World Health Organisation and 195 (14.3 %) were not. Most GPs in Germany follow the principles of WHO structured pain therapy. However, further improvement of the results may be achieved through intensive training of colleagues.

Effect of Named, Accountable GPs on Continuity of Care: Protocol for a Regression Discontinuity Study of a National Policy Change.

Introduction: Increasing continuity of care has been identified as a strategy to improve patient outcomes, but previous studies of integrated care have tended to focus on pilot areas, which limit their generalisability and the ability to determine in which contexts integrated care was most successful.Objective: This study protocol describes a quantitative evaluation of a reform in England that introduced named, accountable general practitioners for all National Health Service (NHS) patients aged 75 years or over. The national contract for general practice services required that named general practitioners offer longitudinal continuity of care within the general practice and be accountable for coordinating care to meet the patient’s healthcare needs.Methods: This study will apply a regression discontinuity design to pseudonymised electronic medical records from a sample of general practices in England. We will compare outcomes for patients aged just below and above the age of 75 to estimate the effect of named general practitioners and relate these estimated treatment effects to the characteristics of general practices. Outcomes will include a metric relating to continuity of care, namely the Usual Provider of Care Index, and numbers of general practitioner contacts, referrals to specialist care and diagnostic tests.Discussion: The study illustrates an approach to evaluate national changes aimed at more integrated care using electronic records, which will complement in-depth examination in pilot sites.

Patient burden during appointment-making telephone calls to GP practices

ObjectiveThis study addresses, for the first time, the effectiveness of receptionists handling incoming calls from patients to access General Practice services. MethodsIt is a large-scale qualitative study of three services in the UK. Using conversation analysis, we identified the issue of ‘patient burden’, which we defined based on the trouble patients display pursuing service. We quantified instances of ‘patient burden’ using a coding scheme. ResultsWe demonstrate how ‘patient burden’ unfolds in two phases of the telephone calls: (i) following an initial rejection of a patient’s request; and (ii) following a receptionist’s initiation of call closing. Our quantitative analysis shows that the three GP services differ in the frequency of ‘patient burden’ and reveals a correlation between the proportion of ‘patient burden’ and independent national satisfaction scores for these surgeries. ConclusionUnlike post-hoc surveys, our analysis of live calls identifies the communicative practices which may constitute patient (dis)satisfaction. Practice implicationsThrough establishing what receptionists handle well or less well in encounters with patients, we propose ways of improving such encounters through training or other forms of intervention.

Patient satisfaction with a teleradiology service in general practice.

BackgroundAccessibility to secondary health services is not always easy for patients who live at a great distance of hospital. In these circumstances, transferring diagnostic tools and treatment options to primary care could prove beneficial for patients. To do so, the quality of medical care and the costs and benefits of the approach need to be assessed. However, the patient perspective is equally important, offering important insights.MethodsIn a cross-sectional study we investigate the satisfaction of patients toward a new teleradiology facility offered a general practice on Ameland, an island in the Netherlands.A questionnaire was created based on the Dutch version of the Patient Satisfaction Questionnaire III and completed by all patients after receiving an x-ray in primary care between June 1, 2007 and June 1, 2009. Those who received more than one x-ray in that period were included only once. The technical and interpersonal skills of doctors were rated out the sum score of the questionnaire namely 25 and 30, respectively. Analysis of variance (ANOVA) was used to analyze the differences between the means of the satisfaction subscales and the patient characteristics.ResultsThe response proportion was after reminder 65 % (381/587 patients). Satisfaction with the technical skills of the doctor providing the teleradiology service was 22.4 ± 3.7, while satisfaction with the interpersonal skills of the doctor during the diagnostic phase was 26.8 ± 3.8. Island residents, the elderly, and those with no history of trauma were more satisfied with the technical and interpersonal aspects of the consultation than non-residents, younger patients, and those with a history of trauma.ConclusionPatients in the island community of Ameland experienced high levels of satisfaction with the teleradiology service offered in primary care.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-016-0418-y) contains supplementary material, which is available to authorized users.

Older patient hospital admissions following primary care referral: the truth is in the referring.

Health information has a major role in the planning of future healthcare provision. With current reconfiguration and cost saving measures, further demands are being placed on acute hospitals. To examine the elderly admissions and the referral documentation of older patients admitted to a tertiary level hospital. A retrospective analysis of primary care referral documentation for all acute admissions of patients over 75years to University Hospital Limerick (UHL) over a 2-month period. Documentation was analysed on the basis of patient demographics, presenting complaint and referral source. Primary care referral documentation was then analysed on the basis of presenting complaint, patient demographics, referrer details, and the clinical information provided. Over the 2-month period there were a total of 381 elderly admissions through the Emergency department. The most common presenting complaint was with shortness of breath (21.5%). 42.5% of admissions were from a primary care setting. 31.1% of referrals were typed and 47.0% handwritten. Over 90% of referrals contained the patient's name, date of birth and address. 98.7% of referrals included a presenting complaint and 54% included a past medical history. 20% of referrals listed known drug allergies, while 9.3% documented social history or baseline functional status. Referral letters from general practice and after-hour services were largely similar. Almost all primary care referrals included the required details as per recent HIQA guidelines. The further inclusion of optional information relating to patient social or functional status, which are of particular relevance to the older population may help patient management.

Medical risk assessment in dentistry: use of the American Society of Anesthesiologists Physical Status Classification.

Medical risk assessment is essential to safe patient management and the delivery of appropriate dental care. The American Society of Anesthesiologists Physical Status (ASA PS) Classification is widely used within medicine and dentistry, but has received significant criticism. This is the first UK survey to assess the consistency of medical risk assessment in dentistry. (i) To determine the use and consistency of the ASA PS among dentists and anaesthetists. (ii) To consider the appropriateness of the ASA PS in relation to dental treatment planning and delivery of care. A cross-sectional online questionnaire was distributed to anaesthetists and dental practitioners in general practice, community and hospital dental services. Questions focused on professional backgrounds, use of the ASA PS, alternative approaches to risk assessment in everyday practice and scoring of eight hypothetical patients using ASA PS. There were 101 responses, 82 were complete. Anaesthetists recorded ASA PS score more frequently than dental practitioners and found it more useful. Inconsistencies were evident in the assignment of ASA PS scores both between and within professional groups. Many dental practitioners did not use or find ASA PS helpful, with significant inconsistencies in its use. An awareness of alternative assessment scales may be useful across settings. Accepting its limitations, it would be helpful for all dentists to be educated in ASA PS and its use in medical risk assessment, particularly in relation to conscious sedation.