The impact of a general practice co-operative on accident and emergency services, patient satisfaction and GP satisfaction

Objective. The purpose of this study was to assess the impact of establishing a general practice co-operative on use of A&E services, patient satisfaction and GP satisfaction. Methods. A controlled before and after study of a GP co-operative in Sheffield, UK was carried out. A postal questionnaire was sent to 26 911 people, 13 442 before and 13 469 after the opening of the co-operative, to determine service use, in particular A&E attendance, in the previous 4 weeks. Patient satisfaction was assessed through structured interviews with 653 patients. GP satisfaction was assessed using a postal survey of all 98 Sheffield practices 2 years after the opening of the co-operative. Results. There was no change in the use of A&E services, odds ratio = 1.08 (95% confidence interval 0.60‐1.94). There was no change in patient satisfaction overall, mean difference 0.02 (� 0.32 to 0.36). Sixty-seven per cent of doctors in member practices were much more satisfied with out-of-hours duty compared with 10% in non-member practices (P � 0.001).