Study title

Evaluating effectiveness, safety, patient experience and system implications of different models of using GPs in or alongside Emergency Departments (GPs in EDs)

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Principal / Lead Investigator
Type of study

Realist evaluation using mixed methods

Who is the study sponsor?

Cardiff University


Hospital emergency departments (EDs) are under increasing, sometimes extreme, pressure. Patients are experiencing long hours of waiting to be seen. We have seen media reports of emergency services in crisis. This situation has arisen partly because people attend EDs with problems that GPs could deal with. Finding better ways to assess and treat patients coming to EDs could have a major impact on the experience and care of the millions of people attending EDs and on all NHS services by providing evidence of how best to manage resources.

Many EDs now work closely with GPs in three main ways: 

  • Assessing patients and sending them to a GP clinic next door to the ED;
  • Placing GPs in the ED to make a brief assessment of patients and decide what type of healthcare provider they need to see
  • Placing GPs in the ED as extra staff to provide treatment.           

It is not known how well these arrangements provide care or if they make a difference to how quickly patients receive treatment and referrals for tests and other services. Our study will look at what works, for whom and in what circumstances. 

In this study we will look at: 

  1. What are the different ways of working, how are they are organised and how common are they?
  2. How do they work in practice? Do they do what they were meant to do?
  3. Hospital admissions, re-attendance, waiting times, patient safety and staff and patient satisfaction
  4. What are the key factors that lead to a better service? 
Public / patient involvement

Two public collaborators recruited from the Involving People network are co-applicants for the project, and were actively involved in preparing the funding bid for the study. During the study, the public collaborators have been involved at an operational level, regularly attending co-applicant meetings, playing a key role in drafting patient-facing materials, reviewing patient recruitment methods, overseeing qualitative data analyses, planning and recruiting for stakeholder events and supporting public attendees.

Our public collaborators have produced lay summaries for all publication (below). You can view all lay summaries here.

How could this research potentially benefit patients?

Currently, the effectiveness of each GP-ED model is unclear in terms of its impact on service provision, patient experience and the effectiveness and safety of clinical care delivery. This study plans to address that research gap.

Does the study involve a methodological innovation?

The mixed methods design will use ‘realist evaluation’ to examine the effectiveness of the models in terms of what works, for whom and in what circumstances. 


Health Services and Delivery Research (HS&DR) Programme       

Total grant value

£ 954,863

Start date


End date 



See our newsletter, containing links to all publications and lay summaries, here.

Outputs generated (Reports / Publications)
Conference abstracts

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