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Patients' expectations of OOH services are too high

By Steve Nowottny

Patients have ‘unrealistically high' expectations of out-of-hours care and achieving high levels of user satisfaction will be ‘challenging and potentially costly', according to a new study.

A survey of 1,249 patients by researchers at the Peninsula Medical School and the National Primary Care Research and Development Centre found that while out-of-hours providers are generally meeting national quality requirements on access to care, many patients remain less than fully satisfied.

Even when patients had received a home visit within an hour – the category for the most rapid response – just one third classified the service as ‘excellent'.

The study comes amid continuing debate over how out-of-hours standards should be gauged. Last September a Healthcare Commission report into urgent care found that a third of out-of-hours providers are still failing to meet national quality requirements, while the Primary Care Foundation has embarked on a national benchmarking exercise.

Lead author Professor John Campbell, professor of general practice and primary care at the Peninsula Medical School, said: ‘Patients' expectations are very high, and it's possible that they may be unrealistically high.'

‘Whether the Department of Health would want to adjust the quality requirements or adjust patients' expectations is an interesting question. Certainly when we're in the middle of winter with the kind of problems out-of-hours services now have with upper respiratory infections and flu, it may be realistic to be communicating realistic expectations about what the service can deliver.'

But Dr Agnelo Fernandes, the RCGP's clinical champion in urgent care and a GP in Croydon, warned that out-of-hours providers would also have to raise their game.

‘We always complain when PCTs tick boxes – in many ways we're doing that as well,' he said.

‘To improve performance further beyond the national quality requirements would require resources and also changing the mindset of out-of-hours providers in that they should regard working towards what patients' requirements are as opposed to working towards targets.'

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