GPED: General Practitioners and Emergency Departments: Efficient Models of Care
Funding
National Institute for Health (NIHR) Health Service & Delivery Research (HS&DR) Ref. 15/145/06
What is the research question?
What is the impact of GPs working in or alongside the Emergency Department (ED) on patient care, the primary care and acute hospital team and the wider urgent care system?
What is the differential impact of different service models of GPs working in or alongside EDs?
What is the problem?
Emergency departments (EDs) in the UK are under severe pressure because so many people are using them. This means that staff become stressed and patients may not always get the treatment they need in a timely way. One way of reducing the demand on EDs may be to have General Practitioners (GPs) working in or next to the ED. We know that some patients come to an ED with a problem that can be dealt with by a GP. Some EDs already have GPs working in or next to them, but we don’t know the best way to organise this sort of service, or the effect it has on patients, GPs and other NHS staff. GPs are also relatively expensive and in short supply, so they must be used efficiently.
What is the aim of the research?
We plan to research the different ways that GPs can work in or next to an ED.
How will this be achieved?
In the first phase of our work we will look at all the EDs in the UK that already have GPs in or next to them. We will divide the approaches used in different hospitals into groups, and interview key leaders to find out what they think the benefits are. In phase 2 we will do a full comparison of these EDs using patient, staff and hospital information. We will look at how many patients were seen, what their waiting times were, how long they stayed in hospital and other areas of interest that might be influenced by having a GP in or next to the ED. We will compare a period of time before GPs were introduced with a period of time afterwards, and also EDs that don’t have GPs working in this way. We will then pick six places where GPs are already working in or next to the ED and study them in detail, collecting local information on the way that patients use health services in that area, and interviewing and surveying patients and staff who have experience of GPs working in or next to the ED.
We will then be in a good position to predict what is likely to happen when GPs are introduced to the
ED, and will explore these ideas further in phase three. We will work with four hospitals that are about to start using GPs and will study what happens before and after the change by collecting a wide range of local data, surveying and interviewing staff before and after, observing what happens in the ED on a day-to-day basis and interviewing patients and carers who have used the service. We will consider the things that are important to patients, staff, the hospital and the NHS as a whole, and examine the costs compared to the benefits that can be achieved.
Who is leading the research?
Prof Jonathan Benger, NHS Consultant in Emergency Medicine, University Hospitals Bristol and Weston NHS Foundation Trust and University of the West of England.
Further information:
For more information or to get involved in this project, please contact bnssg.research@nhs.net.