There is a long-term trend of patients going to A&E, rather than out-of-hours services or their GP surgery. It’s been a historic problem for 30 years. If you look at the data from the past 10 years, A&E admissions and emergency admissions have been rising. Demand on OOH care has been going up too.
It can’t be explained by population changes or changes in disease patterns, so what we’re seeing is a behavioural change, although this is a hypothesis rather than something we’ve absolutely demonstrated. In some areas there are patients who attend A&E weekly.
In terms of the QP indicators, there’s not much sign that they’ve had a significant impact. At the level of individual practices, the numbers are small and the information is difficult to interpret.
We were also asking practices to tackle these new QOF indicators at the same time we were asking people to go through NHS reorganisation, so maybe it’s no surprise.
Nigel Edwards is a senior fellow at the King’s Fund
