Service evaluation of “GP at Door” of Accident and Emergency Services in Eastern England

Aims To describe activity and outcomes after streaming low urgency attenders to general practice services at door of Accident and Emergency departments (GDAE), including possible benefits to co-located emergency departments. Methods As a service evaluation, we describe GDAE users, their reasons for presentation, wait times, outcomes and co-located emergency department performance metrics at two hospitals in eastern England. Findings Each GDAE saw about 928 patients per month. Wait times for usual A&E care relatively shortened at only one site. Reattendances were common (about 10% of attenders), 75% of GDAE attenders were seen within 1 hour of arrival, 7% of patients initially allocated to GDAE were referred back to A&E for further investigations, 59% of GDAE patients were treated and discharged with no further treatment or referral required. Pain, injury, infection or feeling generally unwell each comprised > 10% of primary reasons for attendance. Referrals to specialist health services were outcome for 4% and 16% at respective sites. Conclusions About 26,000 A&E attendances appear to have been prevented. Patients were seen quickly at both GDAE sites, while there were more specialist referrals or shorter wait times for usual A&E services at only one site. Process evaluation could illuminate reasons for these differences.