A & E services in Ireland: the potential role of general practice in accident and emergency services

Abstract

Background

In 1996, Irish accident and emergency (A&E) departments had approximately 1.2 million visits. General practitioners (GPs) have been shown to work efficiently in A&E.

Aim

This study aimed to describe the current A&E structures in Ireland and the potential contribution of general practice.

Method

Questionnaires were sent to all 43 Irish A&E departments seeking information on staffing levels, training posts and interest in the role of GPs within the department.

Results

Thirty-four (79%) hospitals responded, representing at least 71% of all A&E visits. Eleven (32%) had A&E consultants. In 16 (47%) hospitals the A&E department was supervised by other consultants; in 14 supervision was for five hours per week or less. Seven hospitals had no consultant supervision. Twenty-six (76%) had NCHDs assigned to the department. Only 11% of NCHDs were in training in A&E medicine. Six departments employed GPs but 28 said they would like to do so. Most wished GPs to see non-urgent cases but one-third wished them to see all cases. Current staffing levels had little relationship with departmental workload.

Conclusions

The limited consultant supervision and small numbers of NCHDs in training for A&E medicine raise concerns about staffing. Most hospitals want GPs to work in their A&E departments. This has implications for training and for the interface between general practice and the A & E department.