G327(P) Children and young people seen in a co-located primary care hub; an observational study

James, David; Kithany, Heena; Robbins, Alan S.; Crouch, Robert

doi:10.1136/archdischild-2019-rcpch.318

Association of Paediatric Emergency Medicine 2019

DOI: 10.1136/archdischild-2019-rcpch.318

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G327(P) Children and young people seen in a co-located primary care hub; an observational study

David James

Heena Kithany

Alan S. Robbins³

et al.

Abstract: patient and parental satisfaction after PPS to ensure the service we provide meets their needs.Abstract G326(P) Table 1 Participant demographics, n=46 Healthcare professional Number PED Nurse 22 PED Doctor 15 Speciality Doctor 9Abstract G326(P) Table 2 Composite Likert scores (0=not at all, 10=very); n=46; mean (standard deviation) Statement Composite scores I can access PPS 6.0 (±2.7)PPS offers a good alternative to general anaesthesia 9.2 (±1.2) PPS is an efficient process 8.5 (±1.6) PPS provides a good serv… Show more

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2024

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Primary care clinicians working in or near hospital emergency departments in the UK: A mixed methods systematic review

Wilsher,

Brainard,

Hanson

et al. 2024

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ObjectivesTo synthesise evidence about primary care clinicians treating patients in or adjacent to hospital emergency departments in the UK.Study designMixed methods narrative systematic review.MethodsEligible studies were in English and described primary care services (general practitioners, GPs, or nurse practitioners) that treat patients within or adjacent to hospital Emergency Departments (ED). Searches were conducted on Medline, EMBASE, Cochrane Library and CINAHL databases. The search included extraction from an international review updated from 2020 to October 2022, and grey literature from inception to October 2022. The methods were informed by consultation with members of the public.ResultsFrom 4189 studies screened, 20 met inclusion criteria. Four studies assessed typology and streaming of services. Seven studies reported patient and public involvement. Ten studies reported differences in clinical outcomes between primary care and emergency services, but not definitive benefit for either. Likewise, results were equivocal for economic evaluations. Diverse delivery formats complicate evaluation and may explain why clinicians had mixed opinions about the utility of such services. Patients were generally satisfied with the service they received, in either primary care or emergency services.ConclusionDiversity of implementation complicate conclusions that can be drawn. Existing evaluations provide little evidence that primary care services in or near emergency departments offers any system advantages for clinical outcomes, or cost savings. Process evaluation in future evaluations is essential to understand what aspects of primary care at emergency departments are likely to improve system and patient care.Implications for the profession and/or patient careThe systematic review assessed outcomes arising due to primary care clinicians providing treatment in or near Emergency Departments (ED) in the UK. There were no consistent benefits for having primary care clinicians in or near EDs. This research highlights the need for healthcare leaders and policy makers to provide more clarity in developing primary care services in or near EDs. It will have impact for leaders in healthcare to consider whether primary care clinicians in or near EDs are providing ‘best value’ healthcare, or whether other models could provide patients appropriate NHS resources according to their health need.Patient and public involvementThree focus groups (with 13 public advisors) were conducted to understand patients’ priorities and perspectives for attending EDs with relatively minor health conditions. This helped to guide study design, data extraction and analysis of this review.

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Primary care clinicians working in or near hospital emergency departments in the UK: A mixed methods systematic review

Wilsher,

Brainard,

Hanson

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

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G327(P) Children and young people seen in a co-located primary care hub; an observational study

Cited by 1 publication

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Primary care clinicians working in or near hospital emergency departments in the UK: A mixed methods systematic review

Primary care clinicians working in or near hospital emergency departments in the UK: A mixed methods systematic review

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