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Table 3 Summary recommendations for policy and practice

From: Realist analysis of whether emergency departments with primary care services generate ‘provider-induced demand’

Access

Local primary care services need greater capacity.ED pathways must direct patients to other hospital services (such as ambulatory care) and community primary care services

Appropriate referrals

111 services must consider capacity for primary care at EDs and refer to community primary care services, referring appropriate patients to primary care services in EDs only with appointments..

Publicity

Media about service developments must include education about when access to EDs /primary care services is appropriate.

Waiting times

Limits are needed on the number of patients who are referred to EDs from areas that hospitals are not commissioned to treat.

Education

Information and support should be provided to patients in specific population groups (for example tourists) to support them to register with community primary care services