Researchers have said the effect of commissioners’ decision to move A&E services away from GP-led urgent care centres is ‘unclear’, after finding that a quarter of urgent care centre patients needed same-day A&E treatment.
The study, carried out by Imperial College London academics, analysed data for the urgent care centres at Charing Cross and Hammersmith Hospitals in north-west London, over the period October 2009 to December 2012.
It found that most people attending GP-led urgent care centres were dealt with solely by the urgent care team, but just over a quarter needed to be sent to A&E or other specialist departments on the same day.
NHS England is pushing GP-led urgent care centres as part of its drive to manage more people in the community and reduce A&E admissions and the Royal College of Emergency Medicine has proposed that co-locating GP-led urgent care clinics with emergency departments will cut workloads for busy A&E departments.
However, the study’s authors point out that the A&E at Hammersmith Hospital closed in September last year, while the future of the Charing Cross A&E is uncertain because of plans to further centralise emergency services in London.
The researchers found that, of 243,042 attendances at the centres, 74% were managed solely by the urgent care centre while 17% were referred on to A&E on the same day, 6% to other specialty departments and 3% to fracture or soft tissue injury management clinics.
Lead author Dr Thomas Cowling, NIHR research fellow at Imperial, said that since most visits can be managed by a GP or emergency nurse practitioner, ‘most attendees are unlikely to be largely affected by the closure or “downgrading” of the emergency departments at Charing Cross and Hammersmith Hospitals’.
However, he added: ‘Still, a large number of visitors require emergency department or hospital services each year, and the implications for these patients’ health outcomes and experiences are unclear.’