Skip to main content

Most patients requiring urgent care can be managed by a GP or emergency nurse practitioner

Charing Cross and Hammersmith Hospitals’ accident and emergency services will be reconfigured under current plans for reconfiguring health services in North West London. Both hospitals currently have a GP-led urgent care centre co-located with an emergency department. Patients who refer themselves for emergency care are unable to access the emergency department without being seen by a GP or emergency nurse practitioner in an urgent care centre. We present early data on the evaluation of the two the urgent care centres that was published in a letter in the BMJ.

From 1 October 2009 to 31 December 2012, 282 947 unplanned attendances occurred at these centres, 63.2% of them at Charing Cross Hospital. The annual number of attendances increased by 9.4% (7911) from 2010 to 2012 (92 303 in 2012). Most attending patients (85.3%) were registered with a general practice, and 47.7% of attendances occurred outside of general practice core hours. The most common category of primary diagnosis was “injury” (24.1%).

Patients were referred to the co-located emergency departments in 18.0% of attendances (13.4% self referred; 4.6% referred by GP). The risk of referral in patients aged 65 years and over (33.2% of attendances) was significantly greater than in those aged 0 to 15 (8.2%), 16 to 24 (12.9%), 25 to 49 (16.5%), and 50 to 64 years (25.9%).

In conclusion, most patients attending urgent care centres can be managed by a GP or emergency nurse practitioner. A protocol for the evaluation can be viewed in JRSM Open. Full results from the evaluation will be available later in 2014 or in 2015. 

Comments

Post a Comment

Popular posts from this blog

What is the difference between primordial prevention and primary prevention?

Primordial prevention and primary prevention are both crucial strategies for promoting health, but they operate at different levels. Primordial prevention aims to address the root causes of health problems and improve the wider determinants of health. It focuses on preventing the emergence of risk factors in the first place by tackling the underlying social, economic, and environmental determinants of health. This involves broad, population-wide interventions such as: Policies that promote healthy food choices: Think about initiatives like taxing sugary drinks to discourage unhealthy consumption, or providing subsidies for fruits and vegetables to make them more accessible. Urban planning that prioritises well-being: This could include creating walkable neighborhoods with safe cycling routes, ensuring access to green spaces for recreation and relaxation, and designing communities that foster social connections. Social programs that address inequality: Initiatives aimed at reducing pov...
Post a Comment
Read more

UK Covid-19 Inquiry - The Importance of a Strong Primary Healthcare System

In my witness statement for Module 10 of the UK Covid-19 Inquiry, I discuss the pandemic's impact through from the perspectives of  primary care and public health, drawing on my extensive experience as a senior academic at Imperial College London and as a practising GP and NHS Public Health Specialist.  I emphasise that the pandemic disproportionately affected people who were clinically vulnerable, the disabled, ethnic minority communities and those living in deprived areas. The pandemic highlighted how structural inequalities, multigenerational housing, and employment in high-risk frontline roles exacerbated health disparities.  My statement also critiques the weakening of public health infrastructure - particularly for the control of infectious diseases - and the lack of integrated health data systems to identify at-risk groups such as the clinically vulnerable. I also advocated for a more robust preventive healthcare model that prioritises community-based primary care ...
Post a Comment
Read more

Protecting Young People from Meningococcal B Disease: The NHS Targeted Vaccination Programme

Meningococcal group B (MenB) infections are rare but can have devastating consequences. The decision to offer a targeted two-dose vaccination programme to Year 13 students and young people entering university or residential further education reflects concerns about recent outbreaks of meningococcal disease and the higher risk of transmission when large numbers of young adults mix closely for the first time in shared accommodation. The MenB vaccine has a well-established safety record, and evidence from the UK infant immunisation programme has shown substantial reductions in disease among vaccinated children. A targeted programme for those entering higher-risk settings is therefore a reasonable precautionary measure while further evidence is gathered on whether the recent increase in clusters represents a temporary fluctuation in disease patterns or a more sustained change in the epidemiology of MenB infection. The success of the programme will depend on achieving high uptake and ensuri...
Post a Comment
Read more