24hr Accident and Emergency centres (separate to hospital)

Other countries utilise 24hr A&E centres that have pathology, x-ray, nurses and sometimes physios on site (although not necessarily all for 24hrs). As these centres are common and spread through out, patients will usually present there for minor injuries/GP level issues as it is faster than the hospitals, and it is all provided on site (and free). People present to ED because it is there 24/7, because it will all get done on the same premises, and because it doesn't cost money. If you fix these three problems, ED admissions will decrease. If the A&E centres are near the hospital ED's then you can redirect patients who present to ED with minor problems (or at least suggest to them that the wait is less). 

GP visits in Australia can take days to get, take several visits if you need pathology or x-ray etc, and cost you money for most GP's (and the bulk billing are very busy and hard to get into). 


Why the contribution is important

Unless you solve the three underlying problems of wait time, cost and convenience, patients will continue to present to ED for minor complaints.

by smallang on August 13, 2019 at 01:12PM

Current Rating

Average rating: 4.6
Based on: 6 votes


  • Posted by kathyk August 13, 2019 at 15:12

    I agree that the issues of cost and convenience prevent many people from choosing GPs over ED. Very few GP practices are open out-of-hours, and the only other option are the mobile GPs (in whom not many of us have confidence).

    However, developing an extra 24 hr A&E centre would also be expensive. Would it be possible to have this approach combined with the traditional ED on the same premises (more cost effective). Once triaged the patient could be directed to a 'stream': either the 24hr A&E less critical service or the ED more critical/extensive service. So the staffing etc would be separated from that point on.
  • Posted by RodW August 13, 2019 at 21:07

    Not sure how this can be provided free.
    Even the corporate UBB practices are struggling.
    Concept is otherwise good.
  • Posted by Bowds22 August 16, 2019 at 06:10

    especially for areas where the distance to an ED is difficult. To our areas of increased growth and limited availability of services - 24hr A&E centres would aid in reducing down the numbers in Emergency Departments but with also ensuring that patients requiring increased care can be transferred as required.
  • Posted by smallang August 16, 2019 at 14:58

    I would no doubt be expensive for the government to set-up, but compared to the cost of expanding emergency departments, it should be cheaper to maintain in the long term, as you wouldn't need nearly as extensive facilities or staffing requirements as a full blown ED.

    For example, in terms of the medical imaging alone, PAH ED has two trauma (more expensive) x-ray imaging rooms, 4 rooms with standard x-ray capability, plus a mobile X-ray, a dedicated emergency CT, an ultrasound room, with 2-6 staff to run them (depending on time of day), an A&E usually only has 1 radiographer(/sonographer), & one combined x-ray/ ultrasound room.

    Also, when the minor cases are taken out of ED, staff have more time to attend urgent cases, many of which result in better outcomes (and less expense to the health system) if they are attended to urgently, eg. clot retrieval, coronary angioplasties, infections.......

    Also, the easier we make it for patients to attend, the earlier we pick up their health problems, and the cheaper they are to cure/manage.

  • Posted by Dazza August 19, 2019 at 18:00

    This model is great idea.
    I think what we need to do is partner with local GP services. - in close proximity to the Hospitals.
    Alternatively find a premises close to the Hospital (across the road) and set up a GP clinic that operates 24 hours.
    Blood tests can be completed.
    Imaging that is required out of hours could be completed at PAH rather than on site.
    Bulk-billing of bona fide Medicare card holders can be provided.
    Non card holders can pay a fee.
    This may provide an opportunity for medical staff who wish to pull back from clinical roles to service the community or act in these roles.
    It would attract medical staff as well as QH has a good name in the community and the opportunity to earn a good income with the bonuses that are available to medical practitioners through incentives should see this feasible.
    Some NSW Hospitals already partner with local GP clinics successfully.
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