Providing GPs with access to community-based x-ray services could reduce some of the pressure on Irish Emergency Departments (EDs), doctors have claimed.

Currently in Ireland, if a patient suffers an extremity trauma - damage to one of their limbs, such as their hands or feet - they have to be referred to an ED for diagnostic radiology (x-ray).

In many parts of the world, this is provided by community-based radiological services, known as CR, however access to CR is limited here.

Doctors at Wexford General Hospital decided to look into this further. They analysed a random group of patients who attended Wexford General's ED over a two-month period as a result of an injury to an extremity.

They wanted to assess how many of these patients could have potentially avoided the ED if they had access to CR.

"Our premise was that if GPs had direct access to a CR service, it would ultimately decrease the number of presentations to the ED for radiology purposes," they noted.

They looked at 38 patients with extremity injuries, who were either referred by their GP or they self-presented at the ED.

Almost all of the cases involving a GP referral included a request for an x-ray and among these cases, 21% had a confirmed fracture. Among the people who self-presented, all underwent an x-ray and 17% had a confirmed fracture.

The doctors found that among the patients they assessed, 41% who presented for an x-ray were referred by their GP.

"If there was a service available to general practice that provided community-based radiology with instant reporting, this could potentially decrease the number of attendances to the ED for radiology purposes," the doctors concluded.

They said that with CR, a GP could send their patient for an x-ray, get the report on the x-ray and then refer the patient to the appropriate orthopaedic service, ‘rather than relying on the ED to complete this task'. This would reduce pressure on the ED.

"While our study sample was small, we feel it shows that direct access to a CR service would help the ED, the GP service and ultimately the patient.

"It is also quite possible that if patients are made aware that GPs have direct access to radiological services, many self-referrals to the ED may instead opt to attend primary (GP) care, further decreasing demands on the acute hospital services," they added.

This research was carried out by consultant in emergency medicine, Dr Paul Kelly and interns, Dr James Foley and Dr John Brazil, of Wexford General Hospital. Their findings are published in Forum, the Journal of the Irish College of General Practitioners.