Integrating general practice and hospital services

To evaluate a model of negotiations between six Divisions of General Practice and four teaching hospitals, aimed at creating formal agreements to improve the GP-hospital interface.

The evaluation examined the model's outcomes and participants' experiences. Outcomes were investigated via unstructured interviews with key informants, and analysis of relevant documentation. Participants' experiences were elicited via structured interviews with 11 Divisional members and 14 hospital representatives.

Progress towards agreements was made in all cases, with a full agreement being reached at one hospital. Negotiations are continuing in the remaining hospitals. Additional outcomes were achieved during the process, and included resources and structural arrangements involving GPs. Participants were satisfied with the model, but certain key issues were identified.

This evaluation suggests that for negotiations between GPs and hospitals to be successful, Divisions must be involved and be representative, hospitals must see value in formal agreements, their structure must be considered and the process must be collaborative. In the current policy context, which emphasises primary care, hospitals and GPs are increasingly likely to start working more cooperatively. This model has significant potential to improve the interface between the two parties, through its formal negotiation process, and could easily be adapted to other settings.