Cowling et al have added a useful piece of work to the increasing understanding of acute care and the interface between general practice and accident and emergency (A&E) in England.1 In the absence of good quality data from A&E departments this was a creative use of primary care data to estimate impact of patient access to healthcare services.
However, focus on availability of GP appointments only addresses a sub-section of patients who attend A&E departments. While patients often cite poor availability of GP appointments as a reason for attending A&E, a significant proportion have already seen a GP or not tried to get an appointment. One recent survey of patients with minor ailments found that 32% of A&E attenders had not tried to make a GP appointment and a further 10% came for a second opinion following GP consultation.2
While the increasing strain on general practice will inevitably force more patients into emergency departments we need to recognise that many patients choose A&E in the first instance. Perhaps it is time to accept that patients with minor ailments are as likely to attend an A&E department as see their own GP. Planning resources and standardising training in management of minor ailments across general practice and emergency medicine may do more than the political drive to open GP practices for a few extra hours a day.
- © British Journal of General Practice 2014
