Skip to main content
Top
Published in: BMC Primary Care 1/2020

Open Access 01-12-2020 | Antibiotic | Research article

Paediatric contacts with the UK out-of-hours primary care service and contact outcomes: a regional service evaluation

Authors: George Edwards, Rachel Brettell, Chris Bird, Helen Hunt, Dan Lasserson, Gail Hayward

Published in: BMC Primary Care | Issue 1/2020

Login to get access

Abstract

Background

Demand on hospital emergency departments for paediatric problems is increasing. However, the volume and nature of paediatric health demands placed on other parts of the urgent care system have not been explored. This understanding is an important first step in developing and improving out-of-hospital care. We aimed to describe the volume, nature, and outcomes of paediatric contacts with out-of-hours general practice (OOH GP). We performed a retrospective service evaluation using data from 12 months of paediatric patient contacts with the Oxfordshire OOH GP service.

Methods

A database of contacts with the Oxfordshire OOH GP service was created for a 12 month period from December 2014 to November 2015. Descriptive statistics were calculated using SPSS Version 25.

Results

27,455 contacts were made by 18,987 individuals during a 12 month period. The majority of these were for children aged under 5. Over 70% of contacts were at the weekend. The peak contact period was between 18:30 and 21:30. Over 40% of contacts resulted in advice only (no onward referral, requirement for GP follow up, or prescription). 19.7% of contacts resulted in an antibiotic prescription, most commonly those linked with ear, chest, and throat infections.

Discussion

Paediatric contacts with the Oxfordshire OOH GP service were predominantly in younger age groups and in the evening, with 19.7% resulting in an antibiotic prescription. Almost half of the contacts had no follow up or prescription, suggesting non-prescribing health care professionals could be involved in providing care in OOH GP. Further research should consider how children and their parents can be best supported to optimise OOH consulting.
Appendix
Available only for authorised users
Literature
1.
go back to reference NHS Digital. Hospital Accident and Emergency Activity, 2016–17. NHS Digit [Internet]. 2017; Available from: https://digital.nhs./catalogue/PUB30112. NHS Digital. Hospital Accident and Emergency Activity, 2016–17. NHS Digit [Internet]. 2017; Available from: https://​digital.​nhs.​/​catalogue/​PUB30112.​
2.
go back to reference France NP, Craze JL. Emergency Medicine. Arch Dis Child. 2006;91(Suppl 1):A28–30. France NP, Craze JL. Emergency Medicine. Arch Dis Child. 2006;91(Suppl 1):A28–30.
3.
go back to reference Sands R, Shanmugavadivel D, Stephenson T, Wood D. Medical problems presenting to paediatric emergency departments: 10 years on. Emerg Med J. 2012;29(5):379–82.CrossRef Sands R, Shanmugavadivel D, Stephenson T, Wood D. Medical problems presenting to paediatric emergency departments: 10 years on. Emerg Med J. 2012;29(5):379–82.CrossRef
4.
go back to reference McHale P, Wood S, Hughes K, Bellis MA, Demnitz U, Wyke S. Who uses emergency departments inappropriately and when - a national cross-sectional study using a monitoring data system. BMC Med. 2013;11(1):1–9.CrossRef McHale P, Wood S, Hughes K, Bellis MA, Demnitz U, Wyke S. Who uses emergency departments inappropriately and when - a national cross-sectional study using a monitoring data system. BMC Med. 2013;11(1):1–9.CrossRef
5.
go back to reference Partnership HL, London T. New acute models of care for children and young people. 2017;(April). Partnership HL, London T. New acute models of care for children and young people. 2017;(April).
6.
go back to reference Viner RM, Blackburn F, White F, Mannie R, Parr T, Nelson S, et al. The impact of out-of-hospital models of care on paediatric emergency department presentations. Arch Dis Child. 2018;103(2):128–36.CrossRef Viner RM, Blackburn F, White F, Mannie R, Parr T, Nelson S, et al. The impact of out-of-hospital models of care on paediatric emergency department presentations. Arch Dis Child. 2018;103(2):128–36.CrossRef
10.
go back to reference Cecil E, Bottle A, Cowling TE, Majeed A, Wolfe I, Saxena S. Primary care access, emergency department visits, and unplanned short hospitalizations in the UK. Pediatrics 2016;137(2):e20151492. Available from: http://pediatrics.aappublications.org/cgi/doi/https://doi.org/10.1542/peds.2015-1492. Cecil E, Bottle A, Cowling TE, Majeed A, Wolfe I, Saxena S. Primary care access, emergency department visits, and unplanned short hospitalizations in the UK. Pediatrics 2016;137(2):e20151492. Available from: http://​pediatrics.​aappublications.​org/​cgi/​doi/​https://​doi.​org/​10.​1542/​peds.​2015-1492.
11.
go back to reference Gnani S, Morton S, Ramzan F, Davison M, Ladbrooke T, Majeed A, et al. Healthcare use among preschool children attending GP-led urgent care centres: a descriptive, observational study. BMJ Open. 2016;6(6):1–8.CrossRef Gnani S, Morton S, Ramzan F, Davison M, Ladbrooke T, Majeed A, et al. Healthcare use among preschool children attending GP-led urgent care centres: a descriptive, observational study. BMJ Open. 2016;6(6):1–8.CrossRef
12.
go back to reference Gnani S, McDonald H, Islam S, Ramzan F, Davison M, Ladbrooke T, et al. Patterns of healthcare use among adolescents attending an urban general practitioner-led urgent care Centre. Emerg Med J. 2014. Gnani S, McDonald H, Islam S, Ramzan F, Davison M, Ladbrooke T, et al. Patterns of healthcare use among adolescents attending an urban general practitioner-led urgent care Centre. Emerg Med J. 2014.
14.
go back to reference De Bont EGPM, Lepot JMM, Hendrix DAS, Loonen N, Guldemond-Hecker Y, Dinant GJ, et al. Workload and management of childhood fever at general practice out-of-hours care: an observational cohort study. BMJ Open. 2015;5(5):1–6. De Bont EGPM, Lepot JMM, Hendrix DAS, Loonen N, Guldemond-Hecker Y, Dinant GJ, et al. Workload and management of childhood fever at general practice out-of-hours care: an observational cohort study. BMJ Open. 2015;5(5):1–6.
16.
go back to reference Khan NF, Harrison SE, Rose PW. Validity of diagnostic coding within the general practice research database: a systematic review. Br J Gen Pract. 2010;60(572):199–206.CrossRef Khan NF, Harrison SE, Rose PW. Validity of diagnostic coding within the general practice research database: a systematic review. Br J Gen Pract. 2010;60(572):199–206.CrossRef
17.
go back to reference Hobbs FDR, Bankhead C, Mukhtar T, Stevens S, Perera-Salazar R, Holt T, et al. Clinical workload in UK primary care: a retrospective analysis of 100 million consultations in England, 2007–14. Lancet. 2016;387(10035):2323–30.CrossRef Hobbs FDR, Bankhead C, Mukhtar T, Stevens S, Perera-Salazar R, Holt T, et al. Clinical workload in UK primary care: a retrospective analysis of 100 million consultations in England, 2007–14. Lancet. 2016;387(10035):2323–30.CrossRef
18.
go back to reference Hayward GN, Fisher RFR, Spence GT, Lasserson DS. Increase in antibiotic prescriptions in out-of-hours primary care in contrast to in-hours primary care prescriptions: service evaluation in a population of 600 000 patients. J Antimicrob Chemother 2016;71(9):2612–2619. Available from: http://www.jac.oxfordjournals.org/lookup/doi/https://doi.org/10.1093/jac/dkw189. Hayward GN, Fisher RFR, Spence GT, Lasserson DS. Increase in antibiotic prescriptions in out-of-hours primary care in contrast to in-hours primary care prescriptions: service evaluation in a population of 600 000 patients. J Antimicrob Chemother 2016;71(9):2612–2619. Available from: http://​www.​jac.​oxfordjournals.​org/​lookup/​doi/​https://​doi.​org/​10.​1093/​jac/​dkw189.
19.
go back to reference Colliers A, Coenen S, Remmen R, Philips H, Anthierens S. How do general practitioners and pharmacists experience antibiotic use in out-of-hours primary care? An exploratory qualitative interview study to inform a participatory action research project. BMJ Open. 2018;8(9):e023154 Available from: http://www.ncbi.nlm.nih.gov/pubmed/30269072%0Ahttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC6169767.CrossRef Colliers A, Coenen S, Remmen R, Philips H, Anthierens S. How do general practitioners and pharmacists experience antibiotic use in out-of-hours primary care? An exploratory qualitative interview study to inform a participatory action research project. BMJ Open. 2018;8(9):e023154 Available from: http://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​30269072%0Ahttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC6169767.CrossRef
20.
go back to reference Edelstein M, Agbebiyi A, Ashiru-Oredope D, Hopkins S. Trends and patterns in antibiotic prescribing among out-of-hours primary care providers in England, 2010-14. J Antimicrob Chemother. 2017;72(12):3490–5.CrossRef Edelstein M, Agbebiyi A, Ashiru-Oredope D, Hopkins S. Trends and patterns in antibiotic prescribing among out-of-hours primary care providers in England, 2010-14. J Antimicrob Chemother. 2017;72(12):3490–5.CrossRef
23.
go back to reference Lemiengre MB, Verbakel JY, Colman R, De Burghgraeve T, Buntinx F, Aertgeerts B, et al. Reducing inappropriate antibiotic prescribing for children in primary care: a cluster randomised controlled trial of two interventions. Br J Gen Pract. 2018;68(668):e204–10.CrossRef Lemiengre MB, Verbakel JY, Colman R, De Burghgraeve T, Buntinx F, Aertgeerts B, et al. Reducing inappropriate antibiotic prescribing for children in primary care: a cluster randomised controlled trial of two interventions. Br J Gen Pract. 2018;68(668):e204–10.CrossRef
Metadata
Title
Paediatric contacts with the UK out-of-hours primary care service and contact outcomes: a regional service evaluation
Authors
George Edwards
Rachel Brettell
Chris Bird
Helen Hunt
Dan Lasserson
Gail Hayward
Publication date
01-12-2020
Publisher
BioMed Central
Keywords
Antibiotic
Care
Published in
BMC Primary Care / Issue 1/2020
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-020-01205-x

Other articles of this Issue 1/2020

BMC Primary Care 1/2020 Go to the issue