Postal survey of patients' satisfaction with a general practice out of hours cooperative

Objective: To assess patients' satisfaction with out of hours care by a general practice cooperative compared with that by a deputising service. Design: Postal questionnaire survey. Setting: A general practice cooperative in London and a deputising service operating in an overlapping area. Subjects: Weighted samples of patients receiving telephone advice, a home visit, or attending a primary care centre after contacting either service in an eight week period. Main outcome measures: Patients' overall satisfaction and scores for specific aspects of satisfaction. Satisfaction with telephone advice or attendance at centre compared with home visit. Relation between satisfaction and patient's age, sex, ethnic group, car ownership, preference for consulting own doctor, and expectation of a visit. Results: The overall response rate was 67% (1555/2312). There was little difference in overall satisfaction between patients contacting the cooperative or the deputising service, but patients contacting the latter were less satisfied with the explanation and advice received and the wait for a visit. There were significant differences between patients in different age and ethnic groups, with white patients and those aged over 60 years being more satisfied. Lower scores for overall satisfaction were reported by patients who received telephone advice, those who would have preferred to see their own doctor or who originally wanted a home visit, and those who waited longer for their consultation. Overall levels of patients' satisfaction seemed to be lower than previously reported. Conclusions: There were larger differences in satisfaction between different groups of patients than between different models of organisation for out of hours care. A shift to a service based predominantly on telephone advice may lead to increased patient dissatisfaction. Key messages Recent growth in general practice cooperatives for out of hours care has changed the way that care is delivered, and this study assessed patients' satisfaction with a general practice cooperative compared with a deputising service There was little difference in overall satisfaction between patients contacting the cooperative or the deputising service, but a substantial minority of patients expressed dissatisfaction with some aspects of both out of hours services Patients given telephone advice, especially when they had wanted a visit, and those from non-white ethnic groups were particularly likely to be dissatisfied Lower scores for overall satisfaction were also found in younger patients, those who would have preferred to see their own doctor, and those who waited longer for their consultation If out of hours services are based predominantly on telephone advice patients' satisfaction may decline