Patient satisfaction with out-of-hours services; how do GP co-operatives compare with deputizing and practice-based arrangements?

Background Although the rapid growth in general practitioner (GP) co-operat ives has met with GP satisfaction, little is known about patient satisfacti on. This study compares patient satisfaction with co-operative, GP practice -based and deputizing arrangements within one geographical area 15 months a fter a co-operative had become established; and with telephone, primary car e centre and home consultations within the co-operative. Methods A validated postal questionnaire survey of weighted samples of pati ents making contact with the co-operative, practice-based and deputizing ar rangements was undertaken. Results A total of 1823 (53.2 per cent) patients responded. There were no s ignificant differences between organizations in terms of overall satisfacti on, but patients using practice-based arrangements were significantly more satisfied with the waiting time for telephone consultations (p < 0.001) and more satisfied with waiting times for home visits than deputizing patients (p = 0.020), Within the co-operative, overall satisfaction, satisfaction w ith the doctor's manner and with the process of making contact was greater among those attending the primary care centre, and satisfaction with explan ation and advice received greater than for patients receiving telephone con sultations alone (p<0.01). Those receiving telephone advice reported increa sed information needs and help seeking during the following week (p < 0.05) . Conclusions Overall, patients were as satisfied with the co-operative as wi th practice-based or deputizing service arrangements, although many concern s were expressed about the quality of service provision. Differences in sat isfaction were greater between forms of service delivery within the co-oper ative. Dissatisfaction with telephone consultations needs to be considered, together with issues relating to equity in access to out-of-hours' primary care centre consultations and the potential impact of NHS Direct.