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

Brainard, J. S.; Rice, A.; Hughes, G.; Everden, P.

2023-09-10 primary care research
10.1101/2023.09.09.23295296
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AimsTo describe activity and outcomes after streaming low urgency attenders to general practice services at door of Accident and Emergency departments (GDAE), including possible benefits to co-located emergency departments. MethodsAs a service evaluation, we describe GDAE users, their reasons for presentation, wait times, outcomes and co-located emergency department performance metrics at two hospitals in eastern England. FindingsEach GDAE saw about 928 patients per month. Wait times for usual A&E care relatively shortened at only one site. Reattendances were common (about 10% of attenders), 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. Referrals to specialist health services were outcome for 4% and 16% at respective sites. ConclusionsAbout 26,000 A&E attendances appear to have been prevented. Patients were seen quickly at both GDAE sites, while there were more specialist referrals or shorter wait times for usual A&E services at only one site. Process evaluation could illuminate reasons for these differences.

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