“GP See and Direct” Pilot Service – North Middlesex University Hospital (NMUH)

Extract from Enfield CCG Chief Officer's Report 10th February 2016

“GP See and Direct” Pilot Service –

North Middlesex University Hospital (NMUH)

Enfield CCG with Haringey CCG has recruited the assistance of 20_GPs and 5_Administrators for the duration of the 13 week pilot which is expected to begin work on 17th February 2016. Leaflets are expected to be available in 5_languages and the help of community groups to publicise the approach will be sought

 

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The NMUH trial was to bein on 17th February for a 13week trial period so a mid May finish is expected

Limited evidence to support co-locating GPs in A&E, study suggests

CLICK LINK to GP ONline article

By Nick Bostock on the 11 April 2016

Evidence to suggest that co-locating GPs in A&E departments can reduce demand or improve patient satisfaction is limited, UK research suggests.

UK researchers found little evidence overall to support the use of GPs in A&E, and warned that the findings suggested that their presence may in fact increase demand for urgent or emergency care.

The costs of setting up a GP service inside the front door of A&E departments also outweighed small reported marginal cost savings, the researchers warned in the Emergency Medicine Journal.

Researchers from Sheffield and Bradford said that rising emergency department attendances in the UK and in other countries had prompted health systems to investigate ways to reduce demand.

Primary care patients

They wrote: 'One theory explaining this increased demand suggests that this is attributable mainly to patients with problems more suited to primary care and that diverting such patients away from the emergency department may improve access and care across the system.

'To this end, several models of hospital-based unscheduled care services have been developed that primarily use a workforce consisting of GPs or other primary care clinicians. These have been implemented at significant cost in many cases, but with little evaluation of effectiveness in the context of local health services. In many instances, the introduction of alternative and untested forms of urgent care has failed to reduce emergency department attendances.'

To evaluate the effectiveness of co-locating primary care-led urgent care centres (UCCs) in A&E, the researchers looked at studies of systems in the UK, Netherlands, Australia, Spain, New Zealand, Sweden and Ireland.

Despite successes reported in some areas, the researchers concluded that 'the expected benefits of the introduction of such a service are not a given, with variable outcomes reported'.

Report from Enfield CCG Board Meeting in Public on 11th May 2016

The original proposal was for a GP(s) to be present in NMUH A & E Emergency Department between the hours of 10am to 10pm for A 13 week period from 17th February.

It was reported that based on the data up to the end of March 2016, during the attended hours  the duty GP and the Administrators had been able to assist the 50% of patients who were considered needed non urgent care.

As a result of the knowledge gained, the pilot is being extended for a further 13 weeks with the duty hours being extended to cover a 13 hour day (9am to 10pm)

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