News Release

More A&E visits where access to GPs is worse

Peer-Reviewed Publication

Imperial College London

Patients with more timely access to GP appointments make fewer visits to accident and emergency departments, suggests a study published today.

In the largest analysis of its kind to date, researchers at Imperial College London related A&E attendance figures in England to responses from a national survey of patients' experience of GP practices in 2010-11. One question of this survey asked patients whether they had been able to see a GP within two weekdays when they had last tried.

GP practices whose patients reported more timely access to appointments had lower rates of A&E visits in which the patient referred themselves and was discharged.

With A&E units across England straining under rising demand for urgent and emergency care, many have called for better access to GPs as a way to lower A&E attendances. However, there is no previous evidence to suggest this strategy could be effective at a national level.

According to the analysis, the rate of A&E visits for the fifth of practices with the best access was 10.2 per cent lower than the fifth of practices with the worst access. If the bottom fifth had performed as well as the top fifth, the researchers estimate this would have resulted in 111,739 fewer A&E visits for the year.

The findings are published in the open access journal PLOS ONE.

Lead author Thomas Cowling, from the School of Public Health at Imperial College London, said: "This is the first national evidence of an association between access to GP appointments and rates of A&E attendances in England. Policymakers should consider this relationship when designing plans to reduce the use of A&E departments.

"A new era of service commissioning, led by GPs, has just started in the NHS. It will be interesting to see what effect, if any, this has on access to GP appointments and, in turn, on A&E visits.

"Increasing demand for urgent and emergency care is a major issue in many developed countries, in addition to England. In the United States, the situation is more complex as some patients experience financial barriers to accessing primary care. This is increasingly also the case in some European countries as a result of economic austerity."

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For further information please contact:

Sam Wong
Research Media Officer
Imperial College London
Email: sam.wong@imperial.ac.uk
Tel: +44(0)20 7594 2198
Out of hours duty press officer: +44(0)7803 886 248

Notes to editors

1. T.E. Cowling et al. 'Access to Primary Care and Visits to Emergency Departments in England: A Cross-Sectional, Population-Based Study' PLOS ONE (2013) http://dx.plos.org/10.1371/journal.pone.0066699

2. About Imperial College London

Consistently rated amongst the world's best universities, Imperial College London is a science-based institution with a reputation for excellence in teaching and research that attracts 14,000 students and 6,000 staff of the highest international quality. Innovative research at the College explores the interface between science, medicine, engineering and business, delivering practical solutions that improve quality of life and the environment - underpinned by a dynamic enterprise culture.

Since its foundation in 1907, Imperial's contributions to society have included the discovery of penicillin, the development of holography and the foundations of fibre optics. This commitment to the application of research for the benefit of all continues today, with current focuses including interdisciplinary collaborations to improve global health, tackle climate change, develop sustainable sources of energy and address security challenges.

In 2007, Imperial College London and Imperial College Healthcare NHS Trust formed the UK's first Academic Health Science Centre. This unique partnership aims to improve the quality of life of patients and populations by taking new discoveries and translating them into new therapies as quickly as possible.

Website: http://www.imperial.ac.uk


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