Rapid community-based diagnostics and care – GP Urgent Assessment Service
A pilot of the GP Urgent Assessment Service in South Somerset has demonstrated that urgent care can be delivered safely, rapidly, and effectively within the community, offering a compelling alternative to hospital referral for patients with non-life-threatening conditions.
Impact
- 1,351 patients supported across 1,482 appointments.
- 244 estimated hospital admissions avoided.
- 98% of patients seen within two hours of referral.
- 83% travelled less than 15 minutes; 93% lived within 15 km of the service.
- 46% of respiratory point of care tests influenced the clinician’s treatment decision, and 99% of patient respondents who received this test were glad to have an immediate result.
- High patient satisfaction with positive feedback on the service, staff and the diagnostic capability.
Project summary
An evaluation by Health Innovation South West has shown that the GP Urgent Assessment Service (GPUAS) 19-week pilot in South Somerset West Primary Care Network significantly reduced pressure on hospitals and general practices by combining rapid clinical assessment, enhanced diagnostics, and short-term observation, all delivered closer to home.
The GPUAS was successful in detecting and treating serious conditions, including cancer, heart failure, blood clots and respiratory infections, that may have otherwise gone undiagnosed or led to emergency admissions.
A key feature was the integration of point-of-care testing (POCT) which enabled swift diagnoses and informed treatment decisions. For example, respiratory POCT, including tests for Strep A, was instrumental in reducing unnecessary antibiotic prescriptions and hospital referrals.
During the 19-week pilot, 1,351 patients were supported across 1,482 appointments, and clinicians estimated that 244 hospital admissions were avoided.
There are recommendations to consider triage and referral processes into the service to ensure the patient numbers are high enough to warrant the staffing model that has supported the positive outcomes seen.
Rationale
The GPUAS was established in response to mounting pressures across emergency departments, ambulance services, and general practice. By addressing urgent care needs in a local setting, the service helps to relieve the burden on hospitals and GPs, speed up diagnosis and treatment, and improve patient outcomes through earlier intervention.
POCT enhances the effectiveness of primary care-based urgent care models. Unlike traditional lab tests which can take days to analyse and return, POCT provides real-time insights within minutes to support clinical decision-making, crucial in cases of diagnostic uncertainty.
Respiratory infections account for a large share of GP consultations and antibiotic prescriptions in primary care, yet many of these infections are viral and do not require antibiotics. Respiratory POCT helps to reduce inappropriate antibiotic use and ED visits.
Key stakeholders
- Health Innovation South West evaluated the GPUAS to learn how the service can best support patients with urgent needs within the community and the impact it has on patients and the system, to help with further development of the service. The evaluation also examined the acceptability and impact of introducing POCT within this community-based model.
- Symphony Healthcare Services piloted the GPUAS within the South Somerset West Primary Care Network.
- Siemens Healthineers, Roche and Abbott Diagnostics supplied the POCT machines used in the pilot.
Next steps
Continued investment and support for GPUAS and similar services could enhance the healthcare system’s capacity to manage urgent care needs locally yet effectively. Health Innovation South West will continue collaborating with providers to explore how POCT can be scaled and embedded more widely across community health settings.
The GPUAS has demonstrated that the addition of molecular point of care testing supports the patient pathway, enabling patients to obtain the right diagnosis at the right time at point of need. This evaluation further supports the case for community-based settings closer to home, reducing footfall and burden within secondary care settings.
Gabrielle Du Toit, General Manager, Abbott Rapid Diagnostics, UK, Ireland and Nordics
