GP continuity of care and extended access cut use of A&E

Continuity of care and extended access to general practice in-hours reduces A&E visits and probably emergency hospital admissions, according to an analysis of research from the UK, US and Canada.

A&E: continuity of GP care linked to lower emergency care use
A&E: continuity of GP care linked to lower emergency care use

The size of GP practices and QOF performance were not found to be linked to A&E and emergency hospital visits.

Five studies from the US and Canada assessed by researchers from the University of Bristol showed consistently that continuity of care in general practice – measured by seeing the same GP – was linked to lower attendance at emergency departments.

A UK study, along with one from the US and another from Canada, suggested continuity of care also cut emergency hospital admissions, although a US study on patients with diabetes, CHD and depression found no such reduction.

Evidence from US studies shows extended access to GP practices in-hours reduces attendances at A&E, and results of UK studies point to similar findings, the researchers said.

Access link to A&E visits

The report adds: ‘Patients’ poor perception of primary healthcare access in terms of telephone access, shorter opening hours, no other place to go, refusal of requests for appointments and unmet needs were associated with increased emergency department attendance.’

The report also cites five UK cross-sectional studies that suggest an association between lower satisfaction with GP access and higher rates of admission for patients with long-term conditions.

Practice size, numbers of partners, numbers of partners with MRCGP, or the share of salaried GPs in a practice do not appear to be linked to rates of unscheduled care, the report found.

Dr Alyson Huntley, University of Bristol research fellow and lead author of the report, said: ‘A recent report by the King’s Fund suggested that admissions among people with long-term conditions that could have been managed in primary care cost the NHS £1.42bn per year.

‘This could be reduced by up to 18% through investment in primary and community-based services.

‘Our work has shown that providing continuity of care and making it easier for patients to get access to their GP can help achieve this reduction in unplanned admissions and emergency department attendance.’

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