GPs in EDs: Realist evaluation of GP-ED models

• Research type

  Research Study

• Full title

  A realist evaluation of effectiveness, safety, patient experience and system implications of different models of using GPs in or alongside Emergency Departments

• IRAS ID

  217765

• Contact name

  Adrian Edwards

• Contact email

  EdwardsAG@cardiff.ac.uk

• Sponsor organisation

  Research and Innovation Services, Cardiff University

• Duration of Study in the UK

  2 years, 0 months, 31 days

• Research summary

  Hospital emergency departments (EDs) are under increasing, sometimes extreme, pressure. Patients are experiencing long hours of waiting to be seen. Part of the demand for emergency care has arisen because people attend EDs with problems could be resolved in primary care. To respond to this many EDs use a model of service (GP-ED model) that includes GPs working in one of three ways: assessing patients and sending them back to their GP; assessing patients and sending them to a GP clinic next door to the ED; integrating GPs in the ED to provide treatment.
  Currently there is no clear evidence on the effectiveness of GP-ED models. We will conduct a realist evaluation to provide evidence of how GP-ED models work in different settings and how outcomes (effectiveness and safety of care provided; patient and staff experience; training needs, economic impact) might vary in different situations (including patient, staff and organisational factors) and depending on how different groups of people react to the service. Twelve study sites will be purposively sampled in England and Wales based results of a previous literature review and service evaluation (survey and interview). Three sites will be selected for each GP-ED model and one that does not use GPs. Quantitative data will be collected from NHS about how services are used. Observations and patient and staff interviews will be carried out, followed by final survey of all EDs that use GP models. Stakeholder engagement throughout the project will guide the evaluation. All findings will be integrated to provide evidence on the effectiveness and cost effectiveness GP-ED models across a range of settings and for a range of proposed outcomes. A toolkit will be created that can be used by commissioners and providers to inform review, design and implement models of using GPs for different ED settings.

• REC name

  Wales REC 1

• REC reference

  17/WA/0328

• Date of REC Opinion

  23 Nov 2017

• REC opinion

  Further Information Favourable Opinion