Perspectives of GPs working in or alongside Emergency Departments in England: Qualitative findings from the General Practitioners and Emergency Departments [GPED] Study

Background Around 43% of Emergency Department (ED) attendances can be managed in general practice. Strategies to address this include directing appropriate patients to GPs working in or alongside EDs (GPED). Views of GPs choosing to work in GPED may inform planning and implementation of GPED services as well as wider general practice provision. Aim To explore the experiences and motivations of GPs choosing to work in GPEDs in England, and to identify factors that may support or hinder GPs working in GPED. Design and Setting Thematic analysis of 42 semi-structured interviews of GPs working in 10 GPED case sites across England. Method Qualitative GP interviews from a mixed methods study of GPs in GPEDs were thematically analysed in relation to research aims. Results Four themes were generated: the ‘pull’ of a portfolio career; the ‘push’ of disillusionment with general practice; professional reciprocity; sustainability of GPED services and core general practice. Flexible, favourable working conditions, collaboration and professional development made GPED an attractive workplace, often as part of a portfolio career or after retiring from core general practice. Working in GPED was largely driven by disillusionment with core general practice. Both GPED and core general practice were thought to benefit from GPED GPs’ skills. There were concerns about GPED sustainability and destabilisation of core general practice. Conclusion GPED may extend clinical careers of experienced GPs and support recruitment and retention of more recently qualified GPs. Despite some benefits, GPED may destabilise core general practice and increase pressure on both environments. Keywords General Practitioners; Emergency Department; Qualitative Research; General Practice