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How have co-ops fared in integrating with NHS Direct?

Burnley and Pendle Medical Co-op Phasing in integration gradually. No reduction in workload for

co-op

Blackburn and District Medical Co-op Phasing in integration because of fears over capacity. NHS Direct passes too many calls on as urgent

Shropdoc ­ Shropshire Doctors on Call Gave June deadline for more money or it will quit the pilot due to GP and patient complaints about patient safety, inappropriate referrals, too few calls dealt with by nurse advice and 'double triage'

North Bristol Doctors

Co-op Fully integrated and would like to expand to other co-ops but restricted by funding

I-Doc ­ Isle of Wight Doctors on Call Successful nurse triage but takes time because nurses have to follow protocols

Kensington, Chelsea and Westminster GP Co-op Integrated between midnight and 8am. Needs more NHS Direct capacity to extend integration. GP workload cut by 35 per cent. Co-op wants calls for certain conditions passed straight to GPs.

Dagdoc ­ Dartford and Gravesham Doctors on Call Pulled out last February after GP complaints about slowness, inaccuracy and patient safety. Only integrated on Saturday mornings. No plans to increase integration

Camidoc ­ Camden and Islington Doctors on Call Integrated from midnight to 8am. Needs more NHS Direct capacity to extend integration

Harmoni, west London Fully integrated since 1999. A success, but time taken to answer calls, triage and pass on to co-op too long during peak usage

North Derbyshire Doctors, Chesterfield Increase in referrals to GP co-op, A&E and ambulances but pilot has gone well

Sheffield GP Co-op Fully integrated. Has been running a pilot where NHS Direct nurses fully triage calls for six months. A success

Pendoc ­ Yorkshire Pennine Doctors on Call Fully integrated. Pilot has gone well

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