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May 16, 2026British Journal of General Practice0 citations

Optimising emergency care in a primary care network

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MWM. WilliamsGMGraham MorrisonANAndrew Nelson

Key Points

  • This project aims to identify and address gaps in emergency care delivery within a primary care network.
  • Structured interviews conducted with stakeholders.
  • Root-cause analysis performed using a fishbone diagram.
  • Plan-Do-Study-Act cycles guided the implementation of changes.
  • Emergency protocols were developed and distributed, increasing accessibility.
  • Educational meetings received positive feedback, enhancing staff knowledge and confidence.
  • Digital processes improved stock control and pharmacy supply, ensuring sufficient resources.

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.

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Cite This Study

Williams et al. (2026) studied this question.

synapsesocial.com/papers/6a080b27a487c87a6a40d3dchttps://doi.org/10.3399/bjgp26x745593
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