A&E pressures not down to GP access, study finds

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The rising tide of accident and emergency attendances is being driven by long-term health conditions rather than a lack of GP provision, concludes a study by Queen Mary University of London.

A team of researchers looked at data from 819,590 GP registered patients in 136 practices in East London, and found that having multiple long-term health conditions, such as asthma, diabetes or cancer, was the strongest predictor of A&E attendance.

In fact, they calculated that there was a six-fold increase in emergency department attendance rates in those with four or more long-term conditions, compared to those without any.

The findings, which are published in the British Journal of General Practice, also show that those living in the most deprived areas with four or more long term conditions, who also smoked, had almost three times the rate of A&E attendance, compared to the same type of person living in the least deprived areas.

Moreover, patients with a greater number of A&E attendances also have had higher GP consultation rates which, the researchers note, suggests that increased demand on emergency services is not because of poor access to primary care.

“Contrary to the popular narrative that people are using emergency departments rather than their GP surgery, our research shows that this is not the case,” said lead researcher Sally Hull.

“The same people who attend their GP surgery a lot also attend their emergency department a lot. This is largely because they have multiple long-term health conditions, both mental and physical, and it is these conditions, along with an ageing population, which are driving the high attendance rates.”

"General practice makes the vast majority of patient contacts in the NHS and by doing so we alleviate pressures on Emergency Departments, we don't add to them – this research backs this up with important new data,” said Professor Helen Stokes-Lampard, chair of the Royal College of GPs.

"It is also clear from this research that we need better messaging for the public as to the different medical services available to them, within routine working hours and out, so that our patients know the most appropriate place to turn when they become sick.”

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