Streaming primary urgent care: a prospective approach

Abstract

This is the unspecified version of the paper.This version of the publication may differ from the final published version. The health user survey identified younger rather than older users (mean age of 35.6 years -SD 15.5), where 50% had not seen a health professional about their concern, with over 40% unable to obtain a convenient or emergency appointment with their GP. Over a third of the attendees were already receiving treatment and over 40% of these saw their complaint as an emergency. Over half of respondents expected to see a doctor, one-quarter expected to see a nurse and only 1% expected to see a pharmacist across both services, although WiCs are nurse-led services. More respondents expected a prescription from a visit to a WiC, whereas in the ED a third of respondents sought health advice or reassurance. Conclusion: A number of unscheduled care strategies are, or have just been, developed with the emphasis on moving demand into community-based services. Plurality of services provides service users with a range of alternative access points but can cause duplication of services and repeat attendance. Managing continued increase in emergency and unscheduled care is a challenge. The uncertainties in prospective decision making could be used to inform service development and delivery. Permanent repository link

Potential impacts of general practitioners working in or alongside emergency departments in England: initial qualitative findings from a national mixed-methods evaluation

“…Evaluations of early adopters in the UK and Europe suggested that GPs in the ED could ‘result in reduced rates of investigations, prescriptions, and referrals’, 9 37 increase patient satisfaction 8 and offer patients a greater range of healthcare provision. 38 However, these studies have generally been of poor quality.…”

Reducing inappropriate accident and emergency department attendances:

“…4,26 Both primary studies highlighted variation in walk-in clinic configuration around the UK. 25 Retrospective analyses of A&E utilisation data suggest that 25-55% of attendees could have been treated by walk-in clinics or minor injuries units, 27,28 but there is 4 This finding is supported by the majority of empirical work from the UK with one exception; a study in which a non-significant reduction in GP contact rates was reported. 24 There may be some benefit in reducing repeat attendances: a systematic review 4 cites an interrupted time-series study of patients' behaviour after first-time, low-acuity presentations to a walk-in clinic; it found that patients subsequently decreased their A&E usage by 48% (P<0.001).…”

An evaluation of the quality of Emergency Nurse Practitioner services for patients presenting with minor injuries to one rural urgent care centre in the UK: a descriptive study

“…Policy‐driven changes in the UK have initiated a reconfiguration of traditional models of healthcare delivery with the subsequent growth of different models such as minor injury units (MIUs) and walk‐in centres (Department of Health , Audit Commission , Bickerton et al . ). One such model of healthcare delivery is the urgent care centre (UCC) service that attempts to manage need locally and absorb some of the workload from typically overstretched emergency departments (EDs).…”