Introduction

Recent years have seen an increased focus on measuring how people experience health services to ensure that care and treatment is of the highest quality and safety.1 2 Better patient care experiences are associated with better adherence, clinical outcomes and patient safety, and with lower healthcare utilisation.3 4 In England, the national GP Patient Survey (GPPS) measures patients’ experience of primary care.5 As part of an NHS initiative to improve patient experience and facilitate patient-centred care, GPPS scores are currently reported at the level of general practices, Clinical Commissioning Groups (CCGs) and nationally.

English CCGs are clinically led NHS bodies that commission local health care services. There were 209 CCGs in 2016, though there are now fewer, on account of recent practice-mergers. Although GPPS scores are reported for CCGs, little is known about the influence CCGs have on patient experience scores. We have previously shown that patient experience scores vary considerably between GPs within a practice, and that measures reported at practice level can mask this variation.6 The quality of care or patient experience delivered at any one practice may be influenced by drivers from higher organisations such as CCGs. Recently, CCGs have been shown to influence the rate and accuracy of ‘fast-track’ cancer referrals from English primary care.7 Here, we explore whether there was systematic variation in the quality of patient experience between CCGs compared with variability between practices themselves.