Attendances at Charing Cross and Hammersmith Hospitals’ urgent care centres, 2009-12BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f7035 (Published 27 November 2013) Cite this as: BMJ 2013;347:f7035
- Thomas E Cowling, National Institute for Health Research doctoral research fellow1,
- Farzan Ramzan, research assistant1,
- Azeem Majeed, professor of primary care1,
- Shamini Gnani, senior clinical adviser1
Charing Cross and Hammersmith Hospitals’ accident and emergency services will be reconfigured under current plans.1 Both hospitals currently possess a GP led urgent care centre co-located with an emergency department; self referred patients are unable to access emergency departments without being seen by a GP or emergency nurse practitioner in an urgent care centre. We present administrative data recorded in the urgent care centres.
From 1 October 2009 to 31 December 2012, 282 947 unplanned attendances occurred at these centres, 63.2% of them at Charing Cross Hospital. The annual number of attendances increased by 9.4% (7911) from 2010 to 2012 (92 303 in 2012).
Most attending patients (85.3%) were registered with a general practice, and 47.7% of attendances occurred outside of general practice core hours. The most common category of primary diagnosis was “injury” (24.1%).
Patients were referred to the co-located emergency departments in 18.0% of attendances (13.4% self referred; 4.6% referred by GP). The risk of referral in patients aged ≥65 years (33.2% of attendances) was significantly greater (P<0.001) than in those aged 0-15 (8.2%), 16-24 (12.9%), 25-49 (16.5%), and 50-64 years (25.9%).
Most patients were discharged with GP follow-up (36.1%) or with no follow-up (31.9%). Some patients were also referred to a hospital specialist (8.9%), although not all referrals were urgent.
To conclude, most patients attending these centres can be managed by a GP or emergency nurse practitioner. However, it is unclear how patients who do require emergency department services will be affected by the planned reconfiguration.
Cite this as: BMJ 2013;347:f7035
Competing interests: None declared.
Full response at: www.bmj.com/content/347/bmj.f6593/rr/670959.