Gray, J.T.Walker, A.2020-07-292020-07-292009-07-22Gray, J. T. and Walker, A. 2009. Is referral to emergency care practitioners by general practitioners in-hours effective? Emergency Medicine Journal, 26 (8), 611-612.1472-02131472-020510.1136/emj.2008.059956http://hdl.handle.net/20.500.12417/881Objective: 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.2008.059956enEmergency CareGeneral PractitionersCare ManagementReferral and ConsultationEmergency Medical ServicesJournal Article/Review