GP emergency admissions fall as A&E sends more patients into hospital

The number of patients admitted to hospital by GPs is 17% lower than it was almost a decade ago, according to a study funded by the National Institute for Health Research.

A&E: emergency admissions up as referrals from GPs fall
A&E: emergency admissions up as referrals from GPs fall

It found that 1.12m patients were admitted by GPs in England in 2001/02, compared with 0.93m in 2010/11.

Over the same period, hospital admissions via A&E departments rose by 72%, from 2.1m to 3.6m.

Researchers from Imperial College London, who produced the study, described the findings as ‘curious’, and they said reasons for the simultaneous drop in GP admissions and rise in admissions via A&E was ‘currently unclear’.

They did suggest, however, that one factor behind the figures could be an ‘increased failure of management in primary care and outpatient settings’. Changes in patients’ ‘healthcare-seeking behaviour’, might also explain the statistics.

Most patients make right choice

GPC deputy chairman Dr Richard Vautrey said that despite recent rhetoric, most patients made the right choice when going to see their GP or to A&E, and those who did present to A&E were often elderly frail patients who needed to be admitted.

‘GPs have been working hard to enable as many patients as possible to avoid being admitted to hospital and the reduction in GP referrals is a sign of this, but nevertheless there will always be a need for some patients to be admitted,’ he said.

‘It's also likely that the four-hour A&E target has had an impact, where patients are admitted to avoid breaching the target, and it’s another example of how targets can often hinder good care rather than improve it.’

The report's authors said that new models of urgent care services that employ GPs in A&E departments as gatekeepers to specialist urgent care must be evaluated before being introduced more widely to assess the likely effect on hospital admission numbers.

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