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Leading think-tank busts myth that 2004 GP contract was ‘disastrous’ for A&E



A leading think-tank has dismissed the idea that the 2004 GP contract caused an A&E crisis as a ‘myth’, after the health secretary claimed last year that poor access to GP services is the major factor behind increases in A&E attendances.

In a new myth-buster guide, published today, the influential King’s Fund think-tank said there was ‘no evidence’ that the change in 2004 to make out-of-hours provision optional for GP practices had led to an increase in A&E attendances.

The report found that there was little way of knowing whether people attended A&E because they thought they would not be able to get an appointment with their GP.

The report said: ‘It has been said that more patients are attending A&E because they are unable to get appointments with their GP, while… Jeremy Hunt suggested that changes to the GP contract in 2004 led to increases in A&E attendance by removing responsibility for out-of-hours care from GPs.’

‘Many people who attend A&E could be cared for elsewhere – nearly 40% of patients who attend A&E are discharged without requiring treatment. It is likely that some people who visit walk-in centres or minor injuries units do so in preference to booking an appointment with their GP. However, it is hard to pin down the number of people who go to A&E because they think they will not be able to get an appointment with their GP, whether or not this is the case.’

It added: ‘There is no evidence that changes to the arrangements for providing out-of-hours services have led to an increase in A&E attendances… most people go to A&E during working hours and these hourly patterns in attendances have remained largely unchanged in recent years.’