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GPs in A&E saw patients quicker using ‘fewer resources’

GPs working in A&E see patients quicker, use ‘fewer resources’ and admit less patients without increasing re-attendance rates, researchers have found.

A study of GPs in hospital A&E departments, published in the BMJ, found that they also referred fewer patients and ordered fewer investigations.

But GP leaders have said that while the findings show that GPs are able to treat such patients more efficiently, every GP working in A&E is 'one fewer to work in local practices'.

Researchers assessed the outcomes of GPs placed in the University Hospitals Coventry and Warwickshire NHS Trust between May 2015 and March 2016.

They saw that GPs tended to manage self-reporting minor cases with ‘fewer resources than standard care in A&E, without increasing re-attendance rates’.

Patients seen by GPs were on average less likely to spend over four hours in A&E, while no difference in re-attendance after seven days was found.

The team from the University of Warwick and Cardiff University saw significant differences between GPs and the standard A&E care.

GPs admitted fewer patients, referred fewer patients to other specialists, and ordered fewer radiological investigations, blood tests and investigations.

However they also intervened more, offered more primary care follow-ups and referred more patients to outpatient and other A&E clinics.

Lead author from Warwick Medical School Professor Aileen Clarke, who originally trained and practised as a GP, said: 'At a time when secondary care, especially emergency departments, are struggling to meet demand this model of care will result in a beneficial change in resource use as well as matching patients with the most appropriate specialist to care for them.

'The main challenge is expanding the GP workforce to staff emergency departments as well as surgeries.'

But East Yorkshire GP and BMA GP Committee clinical and prescribing policy lead Dr Andrew Green expressed the worry that ‘opening another lane on the motorway’ could encourage attendance when self-care is ‘more appropriate’.

He said: ‘It is to be expected that GPs with years of training in managing conditions within the community are able to treat such patients more efficiently than our colleagues who have different skills...

‘Every GP working in A&E is one fewer to work in local practices, many of which will be on the point of closure through lack of doctors.'

MPs have previously called on Prime Minister Theresa May to apologise for blaming GPs for the A&E crisis.

Researchers used appointment data to reveal that A&E queues are not caused by patients being unable to get a GP appointment, but rather by the fact that they have long-term health conditions.

Readers' comments (12)

  • Maybe 'A&E' should be called 'Accident & Emergency'. If you don't have either, then seek care/attention elsewhere.

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  • WOW!

    Qualified GPs use fewer resources when compared to an F2 working in A+E? Certainly the work of very junior staff is likely to skew the results.

    A better comparison might have been GP V A+E consultant or GP V very senior A+E registrar.

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  • Vinci Ho

    Ha ha ha
    No matter how you look at this . If this is ‘genuinely’ true ,it only means one thing again:
    The government needs us(GP) MUCH more now than we need it.
    You see , I think Brexiteer like IDS is holding similar soundbite : EU needs UK needs more than UK government needs EU. Ho, ho, ho .
    Which soundbite would you believe more??

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  • Vinci Ho

    Correction
    EU needs UK more than UK government needs EU

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  • How does this fit with previous research showing that the longer the GPS were there, the more they behaved like A&E doctors in terms of requesting tests etc?

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  • Vinci Ho

    And I suppose somebody in charge of Daily M can come out and burn a copy of its paper in front of television. Say sorry to GP is a gesture, to start with .

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  • This is very old news and after a prolonged duration in A&E they start to perform like A&E Reg. A poor use of GP expertise unless protected and defined within secondary care.

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  • Doctor McDoctor Face

    How about more GPs being allowed/encouraged to work in General Practice

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  • So why is the Government encouraging patients to attend A&E instead of GPs by starving Practices of basic funding to do this better job?

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  • AlanAlmond

    Why would this be a surprise? If you replaced a bunch of a&e junior Drs with a&e consultants what do you think would happen, probably the same thing. They can’t do this because they can’t recruit them. The same is true of GPs only the labour pool is so much bigger, and general practice is in such a mess they can get away with stealing a few from their real job to prop up a&e. I thought GPs were trained to go and work in general practice. The fact they are being employed in a&e is just a reflection of where all the NHS budget is focused - i.e. hospitals - they just aren’t interested in funding GPs to work in general practice. Why is it such an enormous intellectual leap to work out the efficiencies might actually be even greater if these people were working where they were trained to work (the community) rather than in the hospital meet and greet department? The emptiness in the thinking of the people who arrange these schemes is so vast it’s little wonder we are so lost.

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