Emergency and acute medical care in over 16s: service delivery and organisation

Extended access to GP services:- Is extended access to GP services, for example during early mornings, evenings and weekends, more clinically and cost effective than standard access?

Extended access to community nursing:- What is the clinical and cost effectiveness of providing extended access to community nursing, for example during evenings and weekends? [See the evidence review on community nursing.]

Limiting emergency department opening hours:- What is the clinical and cost effectiveness of limiting emergency department opening hours, and what effect does this have on local healthcare provision and outcomes for people with medical emergencies? [See the evidence review on emergency department opening hours.]

Minor injury units, urgent care centres and walk-in centres:- Is a minor injury unit, urgent care or walk-in centre clinically and cost effective i) as a stand-alone unit and ii) when located on the same site as an emergency department? [See the evidence review on minor injury unit, urgent care centre or walk-in centre.]

Hospital diagnostic radiology services:- What is the optimal configuration in terms of clinical and cost effectiveness of hospital diagnostic radiology services to support 7-day care of people presenting with medical emergencies? [See the evidence review on 7-day diagnostic radiology.]

Standardised criteria for hospital discharge:- Are standardised criteria for hospital discharge clinically and cost effective in specific medical emergencies? [See the evidence review on standardised discharge criteria.]

'Physician extenders':- What is the clinical and cost effectiveness of providing 'physician extenders' such as advanced nurse practitioners, 'physician associates' and advanced clinical practitioners in secondary care?
[See the evidence review on physician extenders.]

Post-discharge early follow-up clinics:- What is the clinical and cost effectiveness of post-discharge early follow-up clinics for people who have had a medical emergency and are at risk of unscheduled hospital readmission? [See the evidence review on post-discharge early follow-up clinics.]

Hospital escalation policies:- Which components of a hospital escalation policy to deal with surges in demand are the most clinically and cost effective? [See the evidence review on escalation measures.]

Extended access to social care services:- What is the clinical and cost effectiveness of providing extended access to social care services, for example during early mornings and evenings, and 7 days a week?

GPs located in or near emergency departments:- What is the clinical and cost effectiveness of having GPs within or adjoining emergency departments?

Specialised units for older people:- What is the most clinically and cost effective way to configure services to assess frail older people who present to hospital with a medical emergency?

Integrated patient information systems:- What is the clinical and cost effectiveness of different methods for integrating patient information throughout the emergency medical care pathway?

Clinical call handlers:- What is the most clinically and cost-effective use of clinical call handlers in a telephone advisory service in terms of i) the ratio of clinical to non-clinical call handlers and ii) point of access to clinical call handlers in a telephone advisory service pathway? [See the evidence review on non-emergency telephone access and call handlers.]

Remote decision-support technologies:- Are paramedic remote decision-support technologies clinically and cost effective? [See the evidence review on paramedic remote support.]

Primary care-led assessment models:- Which primary care-led models of assessment of people with a suspected medical emergency in the community, such as GP home visits, are most clinically and cost effective? [See the evidence review on GP-led home visits.]

Same-day plain X-ray radiology or ultrasound:- What is the clinical and cost effectiveness of providing GPs with access to plain X-ray radiology or ultrasound with same-day results? [See the evidence review on GP access to radiology.]