Table 3 Reported successes in meeting the aims of each service
Type of service | Aims/ perceived benefits | Quotes |
|---|---|---|
Separate primary care services | Focusing GPs on primary care patients without access to investigations improves flow | “We decided a long time ago that he walk-in centre would do no investigations, so they don’t have access to x-ray, and they don’t have access to blood tests. Because we wanted them to have a quick flow, and that doing investigations slow them down”. (Hospital 11) |
Focusing GPs on primary care patients frees up ED staff to focus on more acutely unwell patients | “Partly it’s about having another pair of hands, another staff member, but it’s also about freeing up ED staff and their skills to see the more injured or acute end of the spectrum, and letting GPs see their appropriate patients”. (Hospital17) | |
Integrated emergency medicine services | Shared governance structure enables load balancing – the ability to share patient lists | “It might be that there’s only one or two patients in the Urgent Care stream and there’s ten in the Emergency Care stream, so again because we all work in one hub essentially and we’re all under one governance hat, a GP can flip streams if there’s something appropriate in the stream next door”. (Hospital 3) |
Multidisciplinary team with a wider range of skills to manage demand | “The big bonus of it is it gives us a bigger staff network to use, to be open and honest with you, it also shares ideas” (Hospital 13) | |
Opportunities for shared learning | “We’ve learnt from our GPs here as well as them learning from us. I think we learn a lot from the GPs here in terms of assessing risk”. (Hospital 9) | |
Adding more value to the cost of employing GPs | “So there’s a lot of non-silo working. I’m not wanting someone being paid good money sitting in a room doing nothing”. (Hospital 13) | |
Using a GP as an autonomous Decision maker vs information collector | “These are fully qualified GPs, they’re senior decision makers, they’re autonomous, they’re not coming back to ask you information, they’re not coming back to ask how to manage patients all the time”. (Hospital 3) |