Exploring the relationship between the quality and availability of primary care services and demand for emergency care

Despite the implementation of a number of programmes, crowded A&E departments and unplanned hospital admissions are now two of the biggest challenges facing the NHS. There is currently a focus on policies to reduce A&E attendances through changes in primary care, despite limited evidence of a relationship between the availability and quality of primary care services and the demands placed on secondary care. 

We will use a newly available administrative dataset of all A&E attendances in England to examine the relationship between the volume and composition of A&E attendances and the accessibility and quality of primary care services. We will develop methodology to identify A&E attendances which could be avoided with better quality primary care and attendances which would be more appropriately treated in primary care. This will establish the extent of the problem and potential scope for interventions. Once we have identified the potential scope for interventions, we will assess where best to target interventions. We will also assess the potential cost-effectiveness of current interventions.