Most evidence on the delivery of diabetes services in primary care has focused on the organization of care rather than on the experiences of health care providers. We evaluated staff satisfaction with respect to access, communication, management advice, and understanding of roles. A postal survey of staff at 35 practices from two inner London primary care organizations was linked to profiles of the practice organization of diabetes care. Data were analysed for 124 staff including 81 doctors and 43 nurses. Only 37 (46%) doctors and 20 (47%) nurses were satisfied with the current system of diabetes care. Overall, there were low levels of satisfaction with access to, communication with, or management advice from other members of the diabetes team. Only 29/81 (36%) of doctors understood clearly either their own role or the role of others but 27/43 (63%) of nurses understood their own role and 23 (53%) understood the role of others. Compared with practices with less satisfied staff, practices where staff were more satisfied showed similar organization of diabetes care in terms of the use of a register, recall system, clinical guidelines, availability of equipment, organization of education programmes or use of audit. Staff were generally dissatisfied with diabetes services, but the level of satisfaction was not associated with practice organization for diabetes care. Since a better team climate has been associated with higher quality care, more work should be done to understand influences on staff satisfaction in the delivery of diabetes care in primary settings.
