By Dr Alex Burrell, NIHR Academic Clinical Fellow in General Practice, Centre for Academic Primary Care, University of Bristol

CAPC researchers, Dr Alex Burrell, Dr Grace Scrimgeour and Dr Matthew Booker have conducted a systematic review and narrative synthesis to assess the evidence on how GPs are used in emergency medical services.

Emergency medical services in the UK are under significant pressure. A considerable proportion of their workload relates to problems that could be dealt with by a GP. Using GPs in emergency medical services, such as the ambulance service, might reduce the number of people being taken to Accident and Emergency (A&E) and may more appropriately meet these patients’ needs. This could also free up ambulances and paramedics to respond to life-threatening emergency calls.

Different roles

GPs have been used in emergency medical services in a number of countries. In some countries, most notably Norway, they are an integral part of the service and are called to see life-threatening emergencies. In other countries, including the UK, there have been pilots to see whether deploying GPs alongside ambulance crews for patients with less severe illness reduces A&E attendance. Evidence from our review suggests that seeing a GP does indeed appear to reduce the chance of being taken to A&E, but it isn’t clear whether this is because the patients involved had less severe illness or because of the involvement of the GP.

What works

For GPs working in emergency medical services, having appropriate training and working well with colleagues of other professional backgrounds were found to be really important. Involving GPs in emergency medical services might serve a different purpose depending on the context, but may help reduce the number of patients with less severe illnesses being taken to A&E. This needs further investigation. With any research involving GPs doing work outside of usual primary care, it is always important to think about the ongoing staffing issues and how this might affect GP workforce retention.

Next steps

We would like to explore which ambulance services in the UK employ GPs and in what capacity. We would like to speak to patients who have experience of seeing a GP when they have dialed 999, and to GPs and other professionals who work with GPs in emergency medical services. Ultimately, we want to understand what, if any, value GPs working in emergency medical services may add for patients and the health service as a whole.

Paper: General practitioner roles in emergency medical services: a systematic mapping review and narrative synthesis. Burrell, Alexander; Scrimgeour, Grace; Booker, Matthew. Published in BJGP Open. 30 May 2023.