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Response to requests for general practice out of hours: geographical analysis in north west England
  1. J Munro1,
  2. R Maheswaran2,
  3. T Pearson2
  1. 1Medical Care Research Unit, University of Sheffield, Sheffield, UK
  2. 2Public Health GIS Unit, University of Sheffield
  1. Correspondence to:
 Dr J Munro, Medical Care Research Unit, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK; 

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The organisation of out of hours general practice (GP) in the UK has changed rapidly in recent years as practice based rotas and deputising services have given way to GP cooperatives in many areas.1 At the same time, the proportion of patients contacting an out of hours service who receive telephone advice only, rather than a face to face consultation, has risen substantially,2 although patients continue to express strong preferences for personal contact with a doctor out of hours.3 We examined the effect of the distance of the patient from the primary care centre on the doctor’s decision to see the patient face to face.


The setting for this study was a town of about 130 000 in the north west of England, with an economy based on traditional manufacturing industries, commerce, and administration. Out of hours primary care services were provided by a single cooperative of 116 general practitioners operating from a primary care centre located in the town centre, serving a total population of 230 000 patients in the town and surrounding suburban and rural areas. The cooperative received about 25 000 calls per year, which were triaged by an on call general practitioner in the primary care centre to receive a home visit (from a second mobile on call doctor), to attend the primary care centre, or to receive telephone advice only.

All calls to the cooperative …

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  • * The Huber-White adjustment provides a robust estimate of standard error for clustered data without making distributional assumptions.

  • Funding: none.

  • Competing interests: none declared.

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