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GP access does not add to A&E pressures, study shows

A&E is not an alternative to seeing a GP, say authors

Jo Carlowe

Tuesday, 16 January 2018

Ease of access to a GP is not a predictor of A&E use, new research* shows.

In a study published in the British Journal of General Practice, it is found that contrary to some previous research, patients who consult their GP more frequently also attend A&E more frequently, and the patients’ experience of access to their GP did not predict their use. In other words, these patients are not using A&E as an alternative to their GPs, but use a combination of services as a response to their health needs.

In this new analysis of information on over 800,000 patients attending emergency departments in London, where usage is highest (attendance rates in London have quadrupled over the last fifty years), Sally Hull and colleagues from Queen Mary University London and Kings College London demonstrated that patients with more severe and complex mental and physical health problems, and those from more socially deprived neighbourhoods, are the heaviest users of emergency hospital services.

These findings emphasise the enormous impact on the cost of providing healthcare created by multimorbidity, and also underline the importance of the social determinants, such as poverty, poor education and isolation, of the use of medical services.

Commenting on the findings, professor Helen Stokes-Lampard, chair of the Royal College of GPs, said: "Patients should only use A&E services in a genuine emergency, and GPs and our teams are working incredibly hard to deliver more consultations than ever across the UK, to ensure that remains the case.

"General practice makes the vast majority of patient contacts in the NHS and by doing so we alleviate pressures on Emergency Departments, we don't add to them – this research backs this up with important new data.”

She added: "It is also clear from this research that we need better messaging for the public as to the different medical services available to them, within routine working hours and out, so that our patients know the most appropriate place to turn when they become sick.

"UK general practice is currently facing intense resource and workforce pressures. Our workload has risen at least 16% over the past seven years, but the share of the overall NHS budget we receive is less than it was a decade ago, and the number of GPs has not risen at pace with demand.

"We urgently need NHS England's GP Forward View, pledging £2.4bn extra a year and 5,000 more GPs, to be delivered in full, so that we continue to deliver the most cost-effective service in the NHS, and deliver the changing care our patients need and deserve."

*Hull S, Homer K, Boomla K, et al. Population and patient factors affecting emergency department attendance in London: retrospective cohort analysis of linked primary and secondary care records.

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