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How have changes to out-of-hours primary care services since 2004 affected emergency department attendances at a UK District General Hospital? A longitudinal study
  1. C Thompson1,
  2. C Hayhurst2,
  3. A Boyle3
  1. 1
    Peterborough District Hospital, Peterborough, UK
  2. 2
    West Suffolk Hospital, Bury St Edmunds, UK
  3. 3
    Addenbrookes Hospital, Cambridge, UK
  1. Correspondence to Miss Catriona Thompson, Peterborough District Hospital, Peterborough PE3 6DA, UK; catriona.thompson{at}


Background: 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.

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

Methods: 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.

Results: 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.

Interpretation: 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.

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  • Competing interests None.

  • Provenance and Peer review Not commissioned; externally peer reviewed.

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