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Objective To explore whether responses to questions in surveys of patients that purport to assess the performance of general practices or doctors reflect differences between practices, doctors, or the patients themselves.

Design Secondary analysis of data from a study of access to general practice, combining data from a survey of patients with information about practice organisation and doctors consulted, and using multilevel modelling at practice, doctor, and patient level.

Setting Nine primary care trusts in England.

Participants 4573 patients who consulted 150 different doctors in 27 practices.

Main outcome measures Overall satisfaction; experience of wait for an appointment; reported access to care; satisfaction with communication skills.

Results The experience based measure of wait for an appointment was more discriminating between practices (practice level accounted for 20.2% (95% confidence interval 9.1% to …