Larger GP practices reduce emergency attendances, says spending watchdog

Patients of larger GP practices are less likely to attend A&E, according to a study by financial watchdog the National Audit Office (NAO).

Research by the NAO published on Friday found a 4% reduction in emergency department attendances for every additional GP in a practice.

The government spending watchdog also found a 3% reduction in attendances for every 1% increase in in the share of funding commissioners spent on community health services.

In 2013 NHS England’s review of urgent and emergency care suggested quality and access to out-of-hours services are strongly associated with A&E attendances.

While the most important factor affecting variation in emergency attendance was the characteristics of the underlying population, the NAO study found a complex relationship between awareness of GP out-of-hours services and A&E use, suggesting awareness of and satisfaction with services may not reduce demand in A&E.

GP out-of-hours care

Areas ‘with better patient awareness of out-of-hours GP care have a lower rate of attendance at A&E during out-of-hours – a 1% increase in out-of-hours care awareness is associated with a 2% reduction in the rate of out-of-hours A&E attendance’, the report said.

However, it added that ‘awareness is not associated with the level of overall attendance at A&E; this may suggest that some of the avoided out-of-hours A&E attendance is being delayed rather than avoided’.

The researchers said they found no association between perceived quality of out-of-hours services and attendance rates overall and during out-of-hours. But satisfaction with overall GP services is ’slightly associated’ with A&E attendance.

‘Patients registered with larger GP practices are less likely to attend A&E – on average, for every extra GP in a GP practice, there is a 4% reduction in the rate of A&E attendance,' researchers said.

The study follows an NAO report published in August 2014 which called on CCGs to step up assurance of GP out-of-hours services because of NHS England’s ‘limited oversight’.

Before commenting please read our rules for commenting on articles.

If you see a comment you find offensive, you can flag it as inappropriate. In the top right-hand corner of an individual comment, you will see 'flag as inappropriate'. Clicking this prompts us to review the comment. For further information see our rules for commenting on articles.

comments powered by Disqus