RT Journal Article SR Electronic T1 Access to general practice and visits to accident and emergency departments in England: cross-sectional analysis of a national patient survey JF British Journal of General Practice JO Br J Gen Pract FD British Journal of General Practice SP e434 OP e439 DO 10.3399/bjgp14X680533 VO 64 IS 624 A1 Thomas E Cowling A1 Matthew J Harris A1 Hilary C Watt A1 Daniel C Gibbons A1 Azeem Majeed YR 2014 UL http://bjgp.org/content/64/624/e434.abstract AB Background The annual number of unplanned attendances at accident and emergency (A&E) departments in England increased by 11% (2.2 million attendances) between 2008–2009 and 2012–2013. A national review of urgent and emergency care has emphasised the role of access to primary care services in preventing A&E attendances.Aim To estimate the number of A&E attendances in England in 2012–2013 that were preceded by the attending patient being unable to obtain an appointment or a convenient appointment at their general practice.Design and setting Cross-sectional analysis of a national survey of adults registered with a GP in England.Method The number of general practice consultations in England in 2012–2013 was estimated by extrapolating the linear trend of published data for 2000–2001 to 2008–2009. This parameter was multiplied by the ratio of attempts to obtain a general practice appointment that resulted in an A&E attendance to attempts that resulted in a general practice consultation estimated using the GP Patient Survey 2012–2013. A sensitivity analysis varied the number of consultations by ±12% and the ratio by ±25%.Results An estimated 5.77 million (99.9% confidence interval = 5.49 to 6.05 million) A&E attendances were preceded by the attending patient being unable to obtain a general practice appointment or a convenient appointment, comprising 26.5% of unplanned A&E attendances in England in 2012–2013. The sensitivity analysis produced values between 17.5% and 37.2% of unplanned A&E attendances.Conclusion A large number of A&E attendances are likely to be preceded by unsuccessful attempts to obtain convenient general practice appointments in England each year.