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Taxonomy of the form and function of primary care services in or alongside emergency departments: Concepts paper

Cooper, Alison; Edwards, Michelle; Brandling, Janet; Carson-Stevens, Andrew; Cooke, Matthew; Davies, Freya; Hughes, Thomas; Morton, Katherine; Siriwardena, Aloysius; Voss, Sarah; Benger, Jonathan; Edwards, Adrian


Alison Cooper

Michelle Edwards

Janet Brandling

Andrew Carson-Stevens

Matthew Cooke

Freya Davies

Thomas Hughes

Katherine Morton

Aloysius Siriwardena

Sarah Voss
Professor of Emergency and Critical Care

Jonathan Benger

Adrian Edwards


Primary care services in or alongside emergency departments look and function differently and are described using inconsistent terminology. Research to determine effectiveness of these models is hampered by outdated classification systems, limiting the opportunity for data synthesis to draw conclusions and inform decision-making and policy. We used findings from a literature review, a national survey of Type 1 emergency departments in England and Wales, staff interviews, other routine data sources and discussions from two stakeholder events to inform the taxonomy. We categorised the forms inside or outside the emergency department: inside primary care services may be integrated with emergency department patient flow or may run parallel to that activity; outside services may be offered on site or off site. We then describe a conceptual spectrum of integration: identifying constructs that influence how the services function—from being closer to an emergency medicine service or to usual primary care. This taxonomy provides a basis for future evaluation of service models that will comprise the evidence base to inform policy-making in this domain. Commissioners and service providers can consider these constructs in characterising and designing services depending on local circumstances and context.


Cooper, A., Edwards, M., Brandling, J., Carson-Stevens, A., Cooke, M., Davies, F., …Edwards, A. (2019). Taxonomy of the form and function of primary care services in or alongside emergency departments: Concepts paper. Emergency Medicine Journal, 36(10), 625-630.

Journal Article Type Article
Acceptance Date Jun 26, 2019
Online Publication Date Sep 7, 2019
Publication Date Oct 1, 2019
Deposit Date Sep 13, 2019
Publicly Available Date Sep 13, 2019
Journal Emergency Medicine Journal
Print ISSN 1472-0205
Electronic ISSN 1472-0213
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 36
Issue 10
Pages 625-630
Keywords Critical Care and Intensive Care Medicine; Emergency Medicine; General Medicine
Public URL


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