Patient-perceived benefits of and barriers to using out-of-hours primary care centres.
BACKGROUND
The rapid growth of GP co-operatives has encouraged the development of primary care centres, but little is known about patients' views and experiences of these new forms of out-of-hours service delivery.


OBJECTIVE
This study was designed to understand patients' views, expectations and experiences of attending an out-of-hours primary care centre which was part of an inner London GP co-operative.


METHODS
Systematic samples of patients using the out-of-hours service received semi-structured interviews covering the decision to contact the service, expectations and experience of the service and, if relevant, the experience of travelling to the primary care centre. Interviews were conducted by telephone between 7 and 10 days after patient contact.


RESULTS
Interviews were completed with 55.4% (72/130) of sampled patients who were primary care centre attenders, 50.0% (47/94) of those receiving telephone advice and 45.3% (53/117) of those receiving a home visit. Most attenders of the primary care centre said that they were satisfied with the consultation (90.0%, 65) and were able to get all the help they needed (83%, 60). The speed of being seen and the opportunity of having a face-to-face consultation were key benefits identified. For some, this outweighed difficulties experienced in attending the centre, including arranging transport, caring for other children, managing several children on the journey and travelling while ill. The main barriers patients identified for not wanting to attend the primary care centre included feeling too ill to travel, having other dependants to care for or lacking transportation.


CONCLUSIONS
While primary care centres offer patients speedy access to face-to-face consultations, there are a range of obstacles which are encountered. Those who are socially disadvantaged appear likely to experience greatest difficulty, raising concerns about equity in access to services. Out-of-hours services may need to give consideration to patient transport and a more flexible approach to visiting at home if such inequities are to be avoided.
Department of Palliative Care and Policy, Guy's, King's and St Thomas' School of Medicine, Bessemer Road, London SE5.
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Shipman
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Payne
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Dale
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Jessopp
D016009:Chi-Square Distribution; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D009819:Office Visits / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000592:standards / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000145:classification; D013222:State Medicine / Q000458:organization & administration; D006113:United Kingdom