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Politicians must stop encouraging ‘consumerist’ patient behaviour, concludes A&E study



Medical experts trialling a GP triage system in a busy A&E department have urged politicians to stop encouraging ‘increasingly consumerist’ patient behaviour.

During five weeks this summer, GPs and nurses intercepted patients attenting the A&E department at St George’s Hospital in south London without an obvious condition requiring emergency treatment.

Out of a sample of 150 patients surveyed in connection with the redirection, 56% were sent to their regular GP, 32% to out of hours and 10% to walk-in centres. However patients did not seem to mind, with 83% stating that it had been a positive experience.

Asked why they had attended A&E on that day, 19% of the patients said they felt their condition was serious and needed A&E treatment; 18% said they could not get a GP appointment; 15% said waiting times at their GP practice were too long; and 14% cited convenience as the main reason.

Their most common conditions were musculoskeletal (22%), especially back pain, followed by dermatological (14%).

Commenting on the trial, run by St George’s in collaboration with Care UK and NHS Wandsworth CCG, study leaders said the high number of patients attending because they experienced difficulty with getting a GP appointment confirmed that the crisis in general practice is having ‘a deep impact’ on A&E.

Study leaders Dr Hamed Khan, a GP in Surrey and emergency doctor at St George’s, and medical student Fahima Begun added that in order ’to solve the A&E crisis, policy makers will have to address and solve the GP crisis’.

But they were also concerned with the number of patients attending due to ‘convenience’ and suggesting it ’perhaps confirms the fears that many in the service have about the increasing consumerist ethos that is encroaching on expectations from the health service’.

They said: ’This is deeply worrying as the NHS enters a period of of unprecedented challenges, with an ageing population, worsening financial pressures, and massive staff recruitment and retention problems.

’Politicians who use the NHS as a “political football” and prioritise populist initiatives geared towards convenience rather than need, must also be held to account for their contribution to this.’

The comments come as Prime Minister David Cameron announced on Sunday that the Government will create a new ‘voluntary’ GP contract under which practices have to provide 8am-8pm GP appointments seven days a week.