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Current provision of general practitioner services in or alongside emergency departments in England
BACKGROUND: In 2017, general practitioners in or alongside the emergency department (GPED), an approach that employs GPs in or alongside the ED to address increasing ED demand, was advocated by the National Health Service in England and supported by capital funding. However, little is known about th...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8461443/ https://www.ncbi.nlm.nih.gov/pubmed/33619158 http://dx.doi.org/10.1136/emermed-2020-210539 |
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author | Brant, Heather Voss, Sarah Morton, Katherine Cooper, Alison Edwards, Michelle Price, Delyth Gaughan, James Edwards, Adrian Benger, Jonathan |
author_facet | Brant, Heather Voss, Sarah Morton, Katherine Cooper, Alison Edwards, Michelle Price, Delyth Gaughan, James Edwards, Adrian Benger, Jonathan |
author_sort | Brant, Heather |
collection | PubMed |
description | BACKGROUND: In 2017, general practitioners in or alongside the emergency department (GPED), an approach that employs GPs in or alongside the ED to address increasing ED demand, was advocated by the National Health Service in England and supported by capital funding. However, little is known about the models of GPED that have been implemented. METHODS: Data were collected at two time points: September 2017 and December 2019, on the GPED model in use (if any) at 163/177 (92%) type 1 EDs in England. Models were categorised according to a taxonomy as ‘inside/integrated’, ‘inside/parallel’, ‘outside/onsite’ or ‘outside/offsite’. Multiple data sources used included: on-line surveys, interviews, case study data and publicly available information. RESULTS: An increase of EDs using GPED was observed from 81% to 95% over the study period. ‘Inside/parallel’ was the most frequently used model: 30% (44/149) in 2017, rising to 49% (78/159) in 2019. The adoption of ‘inside/integrated’ models fell from 26% (38/149) to 9% (15/159). Capital funding was received by 87% (142/163) of the EDs sampled. We identified no significant difference between the GPED model adopted and observable characteristics of EDs of annual attendance, 4-hour wait, rurality and deprivation within the population served. CONCLUSION: The majority of EDs in England have now adopted GPED. The availability of capital funding to finance structural changes so that separate GP services can be provided may explain the rise in parallel models and the decrease in integrated models. Further research is required to understand the relative effectiveness of the various models of GPED identified. |
format | Online Article Text |
id | pubmed-8461443 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-84614432021-10-08 Current provision of general practitioner services in or alongside emergency departments in England Brant, Heather Voss, Sarah Morton, Katherine Cooper, Alison Edwards, Michelle Price, Delyth Gaughan, James Edwards, Adrian Benger, Jonathan Emerg Med J Short Report BACKGROUND: In 2017, general practitioners in or alongside the emergency department (GPED), an approach that employs GPs in or alongside the ED to address increasing ED demand, was advocated by the National Health Service in England and supported by capital funding. However, little is known about the models of GPED that have been implemented. METHODS: Data were collected at two time points: September 2017 and December 2019, on the GPED model in use (if any) at 163/177 (92%) type 1 EDs in England. Models were categorised according to a taxonomy as ‘inside/integrated’, ‘inside/parallel’, ‘outside/onsite’ or ‘outside/offsite’. Multiple data sources used included: on-line surveys, interviews, case study data and publicly available information. RESULTS: An increase of EDs using GPED was observed from 81% to 95% over the study period. ‘Inside/parallel’ was the most frequently used model: 30% (44/149) in 2017, rising to 49% (78/159) in 2019. The adoption of ‘inside/integrated’ models fell from 26% (38/149) to 9% (15/159). Capital funding was received by 87% (142/163) of the EDs sampled. We identified no significant difference between the GPED model adopted and observable characteristics of EDs of annual attendance, 4-hour wait, rurality and deprivation within the population served. CONCLUSION: The majority of EDs in England have now adopted GPED. The availability of capital funding to finance structural changes so that separate GP services can be provided may explain the rise in parallel models and the decrease in integrated models. Further research is required to understand the relative effectiveness of the various models of GPED identified. BMJ Publishing Group 2021-10 2021-02-22 /pmc/articles/PMC8461443/ /pubmed/33619158 http://dx.doi.org/10.1136/emermed-2020-210539 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Short Report Brant, Heather Voss, Sarah Morton, Katherine Cooper, Alison Edwards, Michelle Price, Delyth Gaughan, James Edwards, Adrian Benger, Jonathan Current provision of general practitioner services in or alongside emergency departments in England |
title | Current provision of general practitioner services in or alongside emergency departments in England |
title_full | Current provision of general practitioner services in or alongside emergency departments in England |
title_fullStr | Current provision of general practitioner services in or alongside emergency departments in England |
title_full_unstemmed | Current provision of general practitioner services in or alongside emergency departments in England |
title_short | Current provision of general practitioner services in or alongside emergency departments in England |
title_sort | current provision of general practitioner services in or alongside emergency departments in england |
topic | Short Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8461443/ https://www.ncbi.nlm.nih.gov/pubmed/33619158 http://dx.doi.org/10.1136/emermed-2020-210539 |
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