Practices have successfully managed pressure from high risk patients by using nurse led telephone intervention service, it has been revealed.

A study in Yorkshire has found that regular phone contact from nurses significantly cut visits to emergency departments among these patients.

The analysis set out to establish whether the nurse interventions diverted the pressure from emergency departments to general practice – and concluded that, overall, it did not. Emergency department visits in the UK increased by 9% between 2013 and 2017, and 24% of these attendances were avoidable, the researchers say.

In this clinical trial of 363 patients based in the Vale of York, a team started case-management interventions to see if these patients visited their GP more frequently rather than using emergency departments. All of the patients were at high risk of attending emergency departments and for the study, 253 patients were randomised to receive a six-month case management intervention, while 110 received standard care.

The investigators used poisson regression models to calculate monthly rates of primary care use over time for the two years post randomisation and compared both groups.

Writing in the British Journal of General Practice, the team found those receiving intervention led to a 26% reduction in referrals to secondary care services. They say the intervention had differing effects on primary care use in patient groups, with an increase in use in those aged 80 years and over and a decrease in those under 80 years of age.

The authors state: “This may represent a redistribution of services to those with greater clinical need with important associated implications for primary care service planning and provision.”