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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.