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 develop ment of primary care centres, but little is known about patients' views and experiences of these new forms of out-of-hours service delivery. Objectives. This study was designed to understand patients' views, expectat ions 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 rece ived semistructured interviews covering the decision to contact the service , expectations and experience of the service and, if relevant, the experien ce of travelling to the primary care centre. Interviews were conducted by t elephone 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 te lephone advice and 45.3% (53/117) of those receiving a home visit. Most att enders of the primary care centre said that they were satisfied with the co nsultation (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 c onsultation were key benefits identified. For some, this outweighed difficu lties experienced in attending the centre, including arranging transport, c aring for other children, managing several children on the journey and trav elling while ill. The main barriers patients identified for not wanting to attend the primary care centre included feeling too ill to travel, having o ther dependants to care for or lacking transportation. Conclusions. While primary care centres offer patients speedy access to fac e-to-face consultations, there are a range of obstacles wh ich are encounte red. Those who are socially disadvantaged appear likely to experience great est difficulty, raising concerns about equity in access to services. Out-of -hours services may need to give consideration to patient transport and a m ore flexible approach to visiting at home if such inequities are to be avoi ded.