GPs should not provide front-line A&E triage, says former GPC leader

Putting GPs at the front door of A&E to triage patients is the 'wrong model' as it diverts them away from mounting workloads in the practice, a former GPC deputy chairman has warned.

A&E: warnings over value of using GPs to triage arrivals
A&E: warnings over value of using GPs to triage arrivals

Dr Simon Fradd, clinical lead at Southwark CCG, said there was little benefit to using GPs over nurses to triage and redirect patients on the front line of A&E. But using GPs in A&E meant they were not available to help tackle growing practice workloads.

He added that using GPs to perform triage services could also have a negative effect by ‘sucking demand’ away from general practice and into A&E, if patients perceive that it is easier to see a GP immediately at hospital rather than booking an appointment at their local surgery.

Dr Fradd said: ‘We’ve been doing a survey where we compare the redirection rate by GPs and nurse practitioners. What we’ve demonstrated is that there is not a significant difference in redirection rate, and costs are much higher not just financially in using GPs, but in opportunity cost, because you’re taking them away from work they could be doing.’

The number of patients visiting A&E reached 21.7m this year, an increase of over 1m compared to three years ago. Estimates show that up to 50% of people attending A&E end up leaving without receiving any treatment, as their complaints are ‘too trivial’.

Dr Fradd’s comments came at the All Party Parliamentary Group (APPG) inquiry report launch into winter pressures affecting primary care and public health.

But Dr Jim Lawrie, a GP in Newham who also attended the launch, said having GPs screen patients who come to A&E was an effective model that could help ease the strain put on hospital services.

‘Just over nine months ago, we set up GP screening at the front door,’ he said. ‘We have two GPs between the hours of 8am and 11pm, who are seeing all the patients who come to A&E, and that’s managed to reduce considerably the number of patients going through to A&E.'

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