GPs should take on 30% of A&E work, say emergency doctors

A&E doctors have called for more GPs at emergency departments to ease pressure on services, but a senior GP warned it could have the opposite effect.

A&E: report calls for more GP support
A&E: report calls for more GP support

A report by the College of Emergency Medicine (CEM) said co-located primary care services were needed to cater for 15-30% of existing work in A&E departments. The report calls for fundamental change in A&E to ease the crisis of demand on services.

GPC deputy chair Dr Richard Vautrey said co-location had been tried repeatedly but the evidence on its effectiveness was very mixed. One of the problems, he said, was that putting GPs at A&E creates ‘yet another lane on the motorway’ with more people using emergency departments when they realise they can see a GP.

‘Rather than reducing demand it can actually increase demand,' he said. ‘Superficially it might sound like a good idea, but it has been tried and the evidence of its success has been mixed.’

Another problem, said Dr Vautrey, was that GPs working in A&E quickly adopt A&E practices. ‘The governance arrangements of the hospital preclude them from working in the ways they would do in their own general practice.’

The report, based on a survey of 131 UK A&Es between 2011 and 2012, backs system redesign to decongest A&E, expansion and sustainable working practices for staff, changes to emergency care funding and improved performance measures.

CEM president, Dr Mike Clancy, said: ‘We must get this right. The public rightly expects that the emergency department is their ultimate safety net when they are acutely ill or injured. Effective clinical care means safe high-quality care seven days a week that is consistent across the UK.’

Medical director at NHS England, Sir Bruce Keogh, is due to report his findings of a review into urgent and emergency care this spring. The report is expected to set out proposals for a reorganisation of all urgent and emergency care services.

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