How have changes to out-of-hours primary care services since 2004 affected emergency department attendances at a UK...

The delivery of out-of-hours primary medical care in the United Kingdom has changed substantially since 2004, and there has been little examination of the effect that this has on secondary care.

The authors aimed to quantify the change in patient type presenting to our emergency department.

In this study, routinely collected coding data before, during and after the changes were analysed. Each September and October between 1999 and 2006 were included.

There was a steady increase in all attendances at our emergency department. The number and proportions of patients with non-traumatic conditions rose steadily throughout the study period. The number of patients presenting with traumatic conditions stayed the same. The number of patients presenting with non-traumatic conditions out-of-hours rose after the changes were implemented.

The changes to the provision of out-of-hours primary care have been associated with an increase in patients with non-traumatic attendances presenting to our emergency department. This effect is most marked outside of office hours.