Changing GP opening hours might be unlikely to ease rising burden of A&E visits

January 21, 2018

The observational study was led by Imperial College London and is published today in BMJ Quality & Safety.

Lead author Dr Thomas Cowling from Imperial and colleagues compared patients' experiences of GP surgeries with the number of A&E visits in their areas in England from 2011-2012 to 2013-2014. They examined reports from NHS England's annual GP Patient Survey, and included patients registered to 8,124 GP surgeries.

They measured levels of patient satisfaction using three factors: the ease of making an appointment, opening hours, and overall experience. They then matched these responses with A&E departments in their area to observe any correlation with the number of visits to A&E.

Overall, areas where patients were happier with the ease of making appointments, which could be for example by using online booking systems, saw slightly fewer visits to A&E.

However, satisfaction with surgery opening hours and overall patient experience seemed to have no impact on A&E visit rates.

The study suggests that better satisfaction with GP hours, for example because of extended opening hours, does not affect the number of visits made to A&E in their geographical area. However, making the appointment booking process easier for patients was associated with slightly fewer A&E visits in that area.

The authors say their research supports finding alternative options for easing the burden on A&E departments, and might call into doubt the Government's proposals to extend GP surgery hours to ease the burden on A&E departments.

The authors measured satisfaction with hours without linking explicitly them to daytime weekday or evening and weekend appointment availability. They hypothesise that although weekend and evening appointments are convenient for healthy, working aged adults, those who are likely to need medical attention more urgently are older people or those who are chronically ill and not currently working full time.

Senior author Professor Azeem Majeed from Imperial's School of Public health, who is a practicing GP, said: "The government must find alternative ways to handle current pressures on A&E departments. This could include for example improving access to GP appointments during normal opening hours rather than spending scarce NHS resources on extended opening schemes."

Dr Cowling, also from Imperial's School of Public Health, said: "It makes sense to think that extending GP hours will ease the burden on other NHS services, but our study suggests this might not be the case with A&E."
-end-


Imperial College London

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