No evidence to support GPs' role in A&E, report finds

There is little evidence from current projects that GPs working in A&E departments can reduce costs or unnecessary admissions, according to a report.

The report Primary Care and Emergency Departments, by DoH advisors the Primary Care Foundation, estimates that half of all A&E clinics now employ primary care staff to treat patients.

But the study, commissioned by the DoH, found that fewer cases can be treated by GPs than PCTs assume and there is little evidence it drives down NHS costs.

‘We found that the proportion [of arrivals at A&E] that could be classified as primary care cases was between 10% and 30%. This contrasts with widespread assumptions that up to 60% of patients could be diverted to GPs or primary care nurses,' the report says.

‘The stated reason for introducing primary care services is often to improve patient care. Yet we found in many cases the main drivers are, in fact, reducing costs and helping to meet the four-hour waiting time target.'

Dr David Carson, joint director of the Primary Care Foundation, said: ‘Alongside general practice, this [A&E] is the front door of the NHS. Patients know who their GP is and where the nearest emergency department is. So it's vital to get the service right. We were surprised to find there was no evidence that providing primary care in emergency departments could tackle rising costs or help to avoid unnecessary admissions.'

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