• Emerg Med J · Oct 2019

    Editorial Review

    Taxonomy of the form and function of primary care services in or alongside emergency departments: concepts paper.

    • Alison Cooper, Michelle Edwards, Janet Brandling, Andrew Carson-Stevens, Matthew Cooke, Freya Davies, Thomas Hughes, Katherine Morton, Aloysius Siriwardena, Sarah Voss, Jonathan Benger, and Adrian Edwards.
    • Division of Population Medicine, School of Medicine, Cardiff University, UK.
    • Emerg Med J. 2019 Oct 1; 36 (10): 625630625-630.

    AbstractPrimary care services in or alongside emergency departments look and function differently and are described using inconsistent terminology. Research to determine effectiveness of these models is hampered by outdated classification systems, limiting the opportunity for data synthesis to draw conclusions and inform decision-making and policy. We used findings from a literature review, a national survey of Type 1 emergency departments in England and Wales, staff interviews, other routine data sources and discussions from two stakeholder events to inform the taxonomy. We categorised the forms inside or outside the emergency department: inside primary care services may be integrated with emergency department patient flow or may run parallel to that activity; outside services may be offered on site or off site. We then describe a conceptual spectrum of integration: identifying constructs that influence how the services function-from being closer to an emergency medicine service or to usual primary care. This taxonomy provides a basis for future evaluation of service models that will comprise the evidence base to inform policy-making in this domain. Commissioners and service providers can consider these constructs in characterising and designing services depending on local circumstances and context.© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.

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