A&E GPS quick to dole out antibiotics

EMBEDDING GPS in casualty departments to free up emergency staff cuts waiting times and hospital admissions for children, but increases antibiotic prescriptions, a study has shown.

In March, the Government announced a £100million plan to place family doctors in A&E to help weed out patients who did not require specialist treatment, in an effort to crack down on hospital overcrowding.

The measure follows an ongoing increase in A&E admissions which saw half of hospitals issue emergency alerts last winter as they struggled to cope with the numbers.

Now a study by Liverpool University has found that placing GPS in emergency rooms does cut waiting times and admissions, but it also leads to an increase in antibiotic prescribing.

A six-month study at Alder Hey Children’s Hospital in Liverpool, one of Europe’s busiest paediatric A&ES, found that nearly one in five patients could be dealt with by a GP.

However, the family doctors prescribed 26 per cent of children antibiotics, compared with just 20 per cent of those treated by emergency physicians. Professor David Taylor-robinson of Liverpool University’s Institute of Psychology, Health and Society said: “The results presented in this study highlight both the advantages and challenges that can arise when integrating a GP service within a busy paediatric emergency department.

“During this six-month period, patients seen during the hours when the GP was available were significantly less likely to be admitted to hospital, exceed the four-hour waiting target or leave before being seen by someone.

“However, they were more likely to receive antibiotics. Our pilot intervention could be seen as a ‘natural experiment’ that provides some evidence that locating a GP in ED [emergency department] can reduce waiting times and admissions, but increases antibiotic prescribing.”

The NHS has consistently missed its own targets for treating A&E patients on time, and in January analysis showed the number of people stuck for more than 12 hours on trolleys has nearly doubled in the past two years.

However, NHS figures reveal that in 2015-16 38 per cent of A&E patients were sent away having received “advice only”, a rise of almost 4 per cent in only two years, suggesting that huge numbers of patients do not require specialist care by emergency doctors.

Professor Enitan Carrol of Liverpool University’s Institute of Infection and Global Health said embedding GPS in hospitals could allow very ill children to be seen quickly, while making sure symptoms were not missed.

“Long wait times and overcrowding in emergency departments are associated with delays in delivering urgent treatments such as antibiotics for sepsis.”

The study was published in BMJ

Quality and Safety.