Optimising emergency care in a primary care network

Background Emergency care is a primary care challenge, where low-frequency, high-acuity events require safety and excellence. Enhancing these services aligns with organisational values and Care Quality Commission (CQC) standards. This project sought to identify and address gaps in care delivery, stock management, and staff training for the 90 000 patients and 300 staff of all seven Brownlow Health primary care network sites in Liverpool, England. Aim To improve emergency care delivery across Brownlow Health for patient benefit. Method Structured interviews were conducted with stakeholders, site checks performed, and reflective practice considered. A fishbone diagram was used for root-cause analysis across domains of environment, methods, clinical guidelines, equipment, and people. A driver diagram outlined change theories focusing on aligning protocols with authoritative guidance, staff development, and resource availability. Plan-Do-Study-Act cycles guided implementation. Digital stock check processes were established for ongoing audits. Results Emergency protocols were developed and distributed. Emergency bag stock was revised. Educational meetings received positive feedback. Subjective results included increased awareness of emergency procedures, increased confidence to follow guidelines, and improved knowledge of equipment locations. Audit data demonstrated improved protocol access and training uptake. Clinician oversight ensured stock and clinical checks. Digital processes objectively improved stock control and pharmacy supply. Change embedded by establishing monthly managerial site visits. Conclusion This project successfully embedded emergency care enhancements, fostering staff engagement and CQC alignment. Key learning is that pursuing unexpected root causes and leveraging broad stakeholder engagement can have expansive impact. Future annual reviews facilitated by digitalisation will likely sustain improvements.

Authors

Publication Details

Journal
British Journal of General Practice
Published
2026-05-14
DOI
https://doi.org/10.3399/bjgp26x745593
Primary Topic
Emergency and Acute Care Studies
Type
article
Field-Weighted Citation Impact
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article

Optimising emergency care in a primary care network

Graham Morrison, Andrew Nelson, M. Williams
British Journal of General Practice
Emergency and Acute Care Studies
article

Optimising emergency care in a primary care network

Graham Morrison, Andrew Nelson, M. Williams
article en

Abstract

Background Emergency care is a primary care challenge, where low-frequency, high-acuity events require safety and excellence. Enhancing these services aligns with organisational values and Care Quality Commission (CQC) standards. This project sought to identify and address gaps in care delivery, stock management, and staff training for the 90 000 patients and 300 staff of all seven Brownlow Health primary care network sites in Liverpool, England. Aim To improve emergency care delivery across Brownlow Health for patient benefit. Method Structured interviews were conducted with stakeholders, site checks performed, and reflective practice considered. A fishbone diagram was used for root-cause analysis across domains of environment, methods, clinical guidelines, equipment, and people. A driver diagram outlined change theories focusing on aligning protocols with authoritative guidance, staff development, and resource availability. Plan-Do-Study-Act cycles guided implementation. Digital stock check processes were established for ongoing audits. Results Emergency protocols were developed and distributed. Emergency bag stock was revised. Educational meetings received positive feedback. Subjective results included increased awareness of emergency procedures, increased confidence to follow guidelines, and improved knowledge of equipment locations. Audit data demonstrated improved protocol access and training uptake. Clinician oversight ensured stock and clinical checks. Digital processes objectively improved stock control and pharmacy supply. Change embedded by establishing monthly managerial site visits. Conclusion This project successfully embedded emergency care enhancements, fostering staff engagement and CQC alignment. Key learning is that pursuing unexpected root causes and leveraging broad stakeholder engagement can have expansive impact. Future annual reviews facilitated by digitalisation will likely sustain improvements.

British Journal of General PracticeVol. 76(suppl 1)
Openalex Percentile: Top 4%
Emergency and Acute Care Studies
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Optimising emergency care in a primary care network — Graham Morrison, Andrew Nelson, et al. · British Journal of General Practice (2026) | TGRS Research Map | TGRS