Jump in non-emergency A&E attendances since GP out-of-hours opt-out

By Lilian Anekwe

The number of patients attending hospital for minor ailments and non-emergencies has leapt by a third since GPs opted out of out-of-hours responsibility, a new study suggests.

But the number of patients presenting with traumatic conditions has remained the same since the 2004 opt-out, found the research, published in January's Emergency Medicine Journal.

Researchers analysed attendances at an emergency department for a two-month period every year between 1999 and 2006, and compared numbers ‘in hours' with those occurring between 10pm and 8am.

Between 1999 and 2003 non-trauma attendances increased whereas emergency attendances remained stable. The number of patients attending out of hours for non-emergencies increased after this point ‘above what would be expected from extrapolation from 1999-2003 data'.

During the daytime non-trauma attendances rose, but by less than during the nights. The proportion of night-time non-trauma attendance rose, from 42.7% to 57.3%, a 34% relative increase. In-hours, there was only an 11% relative increase.

The findings add to evidence that the opt-out has left many patients confused about how to access out-of-hours services, and appear to back the Department of Health's recent decision to pilot a new non-emergency number in three SHAs across England.

The researchers said the rise coincided with the GP opt-out, but that introduction of the four-hour target for admissions following attendance might also have contributed.

Miss Catriona Thompson, an A&E consultant at the Peterborough district hospital, warned: ‘An increase in patients with non-trauma during night shifts, which are necessarily the last well staffed, may lead to increased waiting times and reduced patient satisfaction.'

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