Intended for healthcare professionals

Letters Reconfiguration in the NHS

Attendances at Charing Cross and Hammersmith Hospitals’ urgent care centres, 2009-12

BMJ 2013; 347 doi: (Published 27 November 2013) Cite this as: BMJ 2013;347:f7035
  1. Thomas E Cowling, National Institute for Health Research doctoral research fellow1,
  2. Farzan Ramzan, research assistant1,
  3. Azeem Majeed, professor of primary care1,
  4. Shamini Gnani, senior clinical adviser1
  1. 1Department of Primary Care and Public Health, Imperial College London, London W6 8RP, UK
  1. t.cowling{at}

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



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