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Same-day GP appointments don’t stop patients from going to A&E, research shows



Patients go to A&E even when offered a same-day GP appointment, a joint report by the Patients Association and the Royal College of Emergency Medicine has shown.

In a survey of 924 A&E attendees, they found that almost half of all patients who had sought a GP appointment before attending A&E had been offered a same-day appointment.

The report concluded the reasons why people attend A&E included convenience and the strength of the A&E ‘brand’ and that it was therefore ‘futile’ to try to discourage people from going.

It recommended that all hospitals move to co-locate GPs to work within A&E departments.

The survey found that nearly a quarter of attendees – which excluded those arriving by ambulance – had tried to see a GP first.

Out of these, almost half (45%) were offered an appointment within three hours of the telephone call; 36% were given a three-day wait; 17% two weeks and 2% ‘over a month’.

The report, titled Time to Act – Urgent Care and A&E, referred to data suggesting 43% of A&E departments currently have a co-located out-of-hours primary care facility, concluding its survey supported a national rollout of such arrangements.

The report said: ‘Such a facility allows patients to choose the A&E brand, decongests the emergency department and makes the best use of currently scarce out-of-hours GP resources.’

Dr Cliff Mann, president of the Royal College of Emergency Medicine, said: ‘Co-location of primary care services has previously been supported by many national organisations and the Keogh Review of Urgent and Emergency Care, but RCEM’s work has shown that in 60% of systems no such co-location exists. Co-location now needs to be implemented.’

The report comes six months after Monitor suggested GP out-of-hours services should be replaced by GP-fronted A&E departments.

In calling for co-location in a report released last summer, the Royal College of Emergency Medicine alongside three other colleges had argued that it was ‘unreasonable’ to expect patients to determine whether their illness is a minor condition or a serious or requiring an A&E visit.

NHS England has also backed the move, with many CCGs using their allocated winter money to place GPs in A&E departments.

However, NHS England admitted that the GP workforce crisis stood in the way of such initiatives, as GP co-location had meant there were not enough to staff out-of-hours shifts and NHS 111 call centres.