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Regional study looks at use of primary care services in EDs

Regional research looks at use of primary care service in EDs in a bid to reduce patient burden in emergency departments.

Locating primary care services within emergency departments (EDs) is among the approaches being adopted to reduce the burden placed on EDs by patients with non-urgent problems. But the effectiveness of such schemes is largely unknown.

This study aimed to identify barriers and facilitators to general practitioner (GP) services in EDs in one region in England.

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Self-report surveys were completed by 13 EDs, and interviews conducted with four ED consultants, an ED nurse and three GPs.

The findings revealed wide variability. Twelve EDs had primary care services and three models were identified: primary care embedded in the ED; a separate primary care service located next to the ED; a GP out-of-hours service on the same hospital site.

Previous research identified issues relating to triage and this study also highlighted problems in steering appropriate patients to the primary care service.

In addition, the researchers found that some embedded GPs had to act as emergency medicine doctors because demand was so great.

The authors conclude that when locating primary care services in EDs, GPs must remain ‘sufficiently distinct’ so their skills are used appropriately. Attention should also be paid to establishing rigorous triaging systems.

Thorough assessment of similar models nationally should be undertaken to establish their impact on patients, staff and the wider emergency care system.

Ablard S, O’Keeffe C, Ramlakhan S et al (2017) Primary care services co-located with emergency departments across a UK region: early views

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