Ascertaining GP demand for a full-time paediatric emergency assessment unit

Abstract

Changes in the general practitioner (GP) contract have led to the development of a variety of models for managing children who become sick outside of GP surgery hours. One such model is the hospital-based 24-hour paediatric emergency assessment unit (PEAU). This study sought to assess the demand for such a service in one English regional health authority. The opinions of general practitioners (GPs) regarding the service were sought via a fax survey, and a retrospective analysis of out-of-hour admissions staying less than 24 hours, over two discrete three-month periods. Differences in GP referral outcomes were also examined. GPs using the current PEAU (N=431) were invited to participate. GP’s responses, and analysis of PEAU out-of-hours throughput and admission trajectories were obtained. Results indicate that 83.9% of respondent GPs strongly agreed or agreed that the unit should provide a 24-hour PEAU service. 987 sick children were admitted to hospital out of PEAU opening hours, of which 404 had a stay of less than 24 hours. There was widespread approval by GPs to implement a 24-hour PEAU service, however, analysis of the hospital data showed that there were currently insufficient out-of-hours admissions to warrant changes in service delivery.