Will alternative immediate care services reduce demands for non-urgent treatment at accident and XXXX ?

@entity1 @entity341 @entity130
OBJECTIVES: To estimate the potential of general practice, @entity130 units, walk in centres and NHS Direct to reduce non-urgent demands on accident and @entity341 (A_E) departments taking into account the @entity1 's reasons for attending A_E. METHODS: A questionnaire survey and notes review of 267 adults presenting to the A_E department of a large teaching hospital in Sheffield, England, triaged to the two lowest priority treatment streams, was conducted over seven weeks. Using defined criteria, @entity1 were classified by the suitability of the presenting health problem to be managed by alternative immediate care services or only by A_E, and also by the likelihood, in similar circumstances, of @entity1 presenting to other services given their reasons for seeking A_E care. RESULTS: Full data were obtained for 96% of @entity1 (255 of 267). Using objective criteria, it is estimated that 55% (95% CI 50%, 62%) of the health problems presented by a non-urgent population attending A_E are suitable for treatment in either general practice, or a @entity130 unit, or a walk in centre or by self care after advice from NHS Direct. However, in almost one quarter (24%) of low priority @entity1 who self referred, A_E was not the first contact with the health services for the presenting health problem. The reason for attending A_E cited most frequently by the @entity1 was a belief that radiography was necessary. The reason given least often was seeking advice from a nurse practitioner. Taking into account the objective suitability of the health problem to be treated elsewhere, and the reasons for attending A_E given by the @entity1 , it is estimated that, with similar health problems, as few as 7% (95% CI 3%, 10%) of the non-urgent A_E population may be expected to present to providers other than A_E in the future. CONCLUSIONS: The increasing availability of alternative services offering first contact care for non-urgent health problems, is likely to have little impact on the demand for A_E services.
