Hospital outpatient services can move safely to primary care, study finds

Much of the care carried out in hospital outpatient clinics could be successfully transferred to primary care, UK research has found.

A study funded by the National Institute for Health Research also recommended GP follow-up as an alternative to outpatient follow-up appointments, minor surgery in primary care, and management of chronic conditions in primary care.

It also found evidence that GPSIs could deliver a 'high quality service that is valued by patients' and that primary care could take on successfully a greater role in chronic care management.

The study pointed to a reversal of the evidence around safety of minor surgery in primary care. In 2006 the researchers found that minor surgery in primary care was associated with 'reductions in quality and safety', but said that new evidence showed it could be safe and effective.

GPonline reported this week on warnings that the loss of funding for a groundbreaking GP minor surgery audit could undermine the growing evidence base demonstrating the safety and effectiveness of this work in primary care.

GP minor surgery

The study, which reviewed previous research as well as running its own sub-studies, found that patients highly value specialist treatment in a primary care or community setting.

But it warned that the cost implications of such a shift were unclear, and it said any changes were more complex than simply changing the place where patients were seen.

The study highlighted the use of better communication, particularly email, between GPs and hospital doctors as one way to cut hospital referrals and treat patients in primary care.

Professor of health services research at the University of Cambridge, Martin Roland, who led the research, said patients were keen to access specialist care in the community but the cost implications of shifting this care away from outpatient departments were not clear.

Photo: Robert Johns/UNP

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