Service evaluation of “GP at Door” of Accident and Emergency Services in Eastern England

Brainard, Julii, Rice, Aiden, Hughes, Gareth and Everden, Paul (2025) Service evaluation of “GP at Door” of Accident and Emergency Services in Eastern England. Primary Health Care Research & Development, 26. ISSN 1463-4236

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Abstract

Aim: We describe activity, outcomes and benefits after streaming low urgency attenders to General practice services at Door of Accident and Emergency departments (GDAE).   Background: Many attendances to A&Es are for non-urgent health problems that could be better met by primary care rather than urgent care clinicians. It is valuable to monitor service activity, outcomes, service user demographics and potential benefits when primary care is co-located with A&E departments.   Methods: As a service evaluation, we describe and analyse GDAE users, reasons for presentation, wait times, outcomes and co-located A&E wait times at two hospitals in eastern England. Distributions of outcomes, wait times, reasons for attendance, deprivation and age groups were compared for GDAE and usual A&E attenders at each site using Pearson chi-square tests and accelerated time failure modelling. Performance in a four hour key performance indicator was descriptively compared for co-located and similar emergency departments.   Findings: Each GDAE saw about 1025 patients per month. Wait times for usual accident and emergency (A&E) care relatively shortened at only one site. Reattendances were common (about 11% of unique patients), 75% of GDAE attenders were seen within 1 hour of arrival, 7% of patients initially allocated to GDAE were referred back to A&E for further investigations, 59% of GDAE patients were treated and discharged with no further treatment or referral required. Pain, injury, infection or feeling generally unwell each comprised > 10% of primary reasons for attendance. At JPUH 4.3% and at QEH 16.1% of GDAE attendances led to referral to specialist health services. GDAE attenders were younger and more socially deprived than attenders to co-located A&Es. Patients were seen quickly at both GDAE sites, but there were differences in counts of specialist referrals and wait times. Process evaluation could illuminate reasons for differences between study sites.

Item Type:	Article
Additional Information:	Data availability statement: Data are only available as reported in this manuscript in aggregate. Data for individual patients are not publicly available.
Uncontrolled Keywords:	emergency department,low acuity presentations,wait times,service evaluation
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health
Depositing User:	LivePure Connector
Date Deposited:	05 Dec 2024 01:31
Last Modified:	16 Jan 2025 01:08
URI:	https://ueaeprints.uea.ac.uk/id/eprint/97898
DOI:	10.1017/S1463423624000707

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