Short Delays in Time to First Contact With Community Health Services and Risk of Emergency Hospital Attendance: Retrospective Observational Study.
Lachlan Cameron, Matt Sutton, Beth Parkinson and 1 others
PMID 41546141WHAT IT FOUND
A short weekend delay in first community health service contact after a primary care referral was not associated with increased emergency department attendance within 56 days, even though Thursday referrals were less likely to be seen on days two or three.
Key findings
01For the group in whom weekend delays created differences in time to first community health service contact, Thursday referrals did not show a higher adjusted probability of emergency department attendance within 56 days than Tuesday referrals.
02Thursday referrals were less likely than Tuesday referrals to have their first community health service contact on days two or three after referral.
03The null finding remained in supplementary analyses using alternate outcome measures, comparing other pairs of referral days, restricting the sample to patients expected to be most impacted by delays, and excluding weeks before and after bank holidays.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only emergency department attendance was measured, so the study says nothing about symptoms, deterioration, patient experience, or other health outcomes. The data were administrative, so they could not capture further primary care use after referral, and ethnicity had missing values. The study was observational, not randomised. It assumed that unmeasured patient severity was similar on Tuesday and Thursday, and one measured severity marker, prior emergency admission, was higher for Thursday referrals. It tested only short weekend-related delays, about one or two days, for patients referred from primary care and first contacted within two to seven days, not longer delays or patients needing same-day contact. The sample was limited to 16 standalone community health service Trusts in England in financial year 2019/20, so it may not apply to other providers, settings, or later periods.
Declared interests
Funded by the National Institute for Health and Care Research Health Services and Delivery Research programme and the National Institute for Health and Care Research Applied Research Collaboration Greater Manchester. The funders had no role in study design, data collection and analysis, decision to publish, or manuscript preparation. The authors declared no conflicts of interest.
The easy way to misread this
Do not read this as proof that community health services can delay contact without harm. It tested only short weekend-related delays in patients referred from primary care and measured emergency department attendance only, not symptoms, deterioration, or patient experience.