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Demise of GP co-ops 'may jeopardise patient safety'

Patient safety could be jeopardised when primary care organisations take over from out-of-hours co-operatives because of the loss of GP

expertise.

The warning from GPs came after a study revealed co-ops had improved doctors' morale without increasing pressure on A&E or damaging patient satisfaction.

Two years after the launch of Sheffield GP Co-operative, 67 per cent of co-op member GPs were more satisfied with their out-of-hours duty. The figure compared with only 10 per cent of GPs in practices not using the co-op, the study in this month's Family Practice found.

A postal survey of 26,911 people before and after the launch of the co-op found no change in their use of A&E services. Interviews with 653 patients also revealed no change in patient satisfaction.

GPs fear this situation will change as a result of the new contract because many co-ops will close or be taken over by PCOs and in several cases will be replaced by services using only nurses and paramedics.

GPs said services would be less safe and other emergency services would face an increase in workload if they were not involved in out-of-hours care.

Dr Steve Hugh, medical manager of Shropshire Doctors on Call and a GP in Telford, said he doubted whether PCOs 'fully understand the out-of-hours agenda'.

'If a service is to be based on paramedics and nurses only it will be unsafe and expensive for services around it, such as ambulances,' he said.

Health minister John Hutton signalled earlier this month he would insist on GPs being involved in new out-of-hours arrangements.

But PCOs said this would add hundreds of thousands of pounds to the cost of their service.

NHS Alliance GMS contract lead Dr David Jenner, a GP in Cullompton, Devon, said some PCOs would find it 'very difficult' to set up a safe service because of workforce issues, lack of planning and failure to engage GPs.

Study author Dr Amanda Howe, professor of primary care at the University of East Anglia and a GP in Norwich, said future research should analyse patient satisfaction, quality of care, clinical outcomes and efficiency.

By Nerys Hairon

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