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Surge in A&E visits more due to complex conditions than shortcomings in GP care, study says

Emergency department presentations more to do with multiple conditions than shortcomings in GP care, study says

Emergency department presentations more to do with multiple conditions than shortcomings in GP care, study says


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Increased attendances at emergency departments are a result of individuals' long-term conditions and not poor quality GP services, a study says.

Queen Mary University of London researchers say that having multiple long-term conditions is the strongest predictor of emergency department attendance. Social deprivation is the second strongest indicator, according to data from 819,590 people registered at 136 GP practices in London.

Complex conditions and socioeconomic status

Writing in the British Journal of General Practice, the researchers noted a six-fold increase in attendance rates of those with four or more long-term health conditions, compared with those with no such conditions.

Attendance for the most deprived population group (366 people per 1,000 of population) was 52% higher than in the least deprived group (240 people per 1,000). Patients attending the emergency department most frequently were also shown to have higher GP consultation rates.

'GPs are an easy scapegoat'

Lead researcher Sally Hull said: ‘The pressures on emergency departments, especially during winter, are enormous.

‘When departments are very busy, with long waits and difficulties finding beds for people needing admission, it is easy to seek scapegoats and suggest that poorly functioning GP services are to blame for the crisis.

‘Contrary to the popular narrative that people are using emergency departments rather than their GP surgery, our research shows that this is not the case.'

Increasing reliance on community-based care

Dr Hull added there are suggestions that emergency department capacity could be reduced and replaced with community-based support.

‘This would require investment in both social care and community health services, and close alignment with the perceived needs of patients seeking urgent care,' she said.

Emergency department attendance rates have more than tripled since the 1960s. The figure was 105 people per 1,000 population in 1961 and in 2015-6 it was to 373 per 1,000 population, according to NHS Digital figures quoted in the study.


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