Authors' recommendations: Urgent and emergency care is a major focus for CCGs. This briefing presents an overview of the evidence for a range of interventions that seek to improve the delivery of urgent and emergency care. Telephone consultations by nurses or dctors appear to be as safe and effective as systems involving more face-to-face contact but effects on service use are mixed. A primary care front end to the emergency department involving GPs could be used to assess and treat patients presenting with less urgent problems. Other workforce models with promise include emergency care practitioners (ECPs) and nurse practitioners. ECPs can reduce patient transport to emergency departments, though this appears dependent on the setting. Interventions with limited evidence of benefit (in terms of reduced waiting times and or length of stay) include 'fast-tracking', rapid assessment zones, triage liason doctors and allowing triage nurses to order tests. The evidence for many interventions is limited and a lack of cost-effectiveness data reinforces the need for rigorous evaluation of service change.

Project Status: Completed

Year Published: 2014

URL for published report: http://www.york.ac.uk/inst/crd/pdf/Evidence%20to%20inform%20urgent%20and%20emergency%20care%20systems.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England

Organisation Name: University of York

Contact Address: University of York, York, Y01 5DD, United Kingdom. Tel: +44 1904 321040, Fax: +44 1904 321041,

Contact Name: crd@york.ac.uk

Contact Email: crd@york.ac.uk

Copyright: University of York