• Is referral to emergency care practitioners by general practitioners in-hours effective?

      Gray, J.T.; Walker, A. (2009-07-22)
      Objective: To evaluate the cost effectiveness to primary care trusts (PCT) in commissioning general practitioner (GP) referrals in-hours to emergency care practitioners (ECP). Methods: A retrospective case note review for patients referred by GPs in-hours to ECP over a 4-month period to ascertain any added value over a GP visit. Results: In a 4-month period 105 patients were referred. In most cases (90.5%) the ECP was utilised as a substitute for a GP rather than providing any additional skills. Defining an avoided attendance as the ECP undertaking an intervention outside a GP skill set this equated to a 9.5% avoided attendance rate compared with the ECP service standard rate of 60%. This has implications both in terms of financial benefit and ongoing ECP service sustainability. Conclusions: There is little value in a PCT commissioning this service as they will pay twice and care must be taken in accepting new referral streams into existing services. https://emj.bmj.com/content/26/8/611. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ DOI http://dx.doi.org/10.1136/emj.2008.059956
    • Paramedic Pathfinder: is it really better than current practice?

      Goulding, James (2014-08)
      Abstract published with permission. Following the recent publication of an article on the Paramedic Pathfinder in the Emergency Medicine Journal, James Goulding argues that rather than highlighting a step forward for the paramedic profession, it serves as an indication that there needs to be more rigorous research before a change in current methods can be recommended.
    • Pre-hospital hypoglycaemia referral pathways

      Bell, Fiona; Fitzpatrick, David (2016-12)
      Abstract published with permission. A short-cut review was carried out to determine whether referral to specialist diabetes services by ambulance crews improves long-term management of a patient’s diabetes. A total of 269 papers were found, of which three represented the best evidence to address the clinical question. The clinical bottom line is that specialist diabetes referrals by ambulance crews responding to an emergency call for hypoglycaemia may be beneficial for patients, although there is insufficient evidence to determine their impact.