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Millions attend A&E due to primary care failure

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An estimated 5.8 million A&E visits occurred last year after patients were unable to see a GP, research from Imperial College has claimed.

Attendances at A&E departments in England have increased by 11 per cent between 2008/2009 and 2012/2013. Research based on interviews with patients has suggested a link between difficulty obtaining appointments with practice nurses or GPs, and increased visits to A&E, but this is the first study to quantify this.

The research team arrived at this figure by estimating the number of GP consultations for the year 2012/2013 based on estimates for previous years and the trend for this figure to increase over time. Next they used patient's accounts of their experiences of their local GP practices from the GP patient survey in 2012/2013 to calculate the ratio of GP appointment attempts that resulted in A&E attendance to attempts that resulted in a GP consultation.

Lead researcher and NIHR doctoral research fellow Thomas Cowling said: 'There has been a lot of talk in recent years about the rising numbers of A&E attendances and the impact that this might be having on A&E departments. It has been suggested that a lack of access to GPs could be a factor but there hasn't been much evidence to back this up. The aim of this analysis was to inform the debate; until now the numerical scale of the problem hadn't been estimated.'

However, the cause and effect might not be that clear cut. Professor Azeem Majid from Imperial's School of Public Health, said: 'It may be that the same patients still go to A&E even if they did get better access to GPs. Secondly, if improving GP access does help there is a need for more research to find out the best way to approach this. Thirdly, it is not clear if increasing numbers of A&E attendances do actually lessen performance in terms of increasing waiting times.'

The study was published in the British Journal of General Practice and can be accesed at:

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