Inappropriate attendance in accident and emergency.

Patients who attend Accident and Emergency (A & E) departments with problems that could be dealt with by their general practitioners (GPs) use time and resources of the department that could be otherwise used for patients with more appropriate needs. Definitions used for inappropriate attendance are drawn from the literature, and the usefulness of the term is discussed in the light of evidence that these patients have logical reasons for attending. Methods of improving the service offered to these patients are discussed, including emergency nurse practitioners, minor injuries units and GPs in the A & E department. The reluctance of GPs to treat minor injuries in their surgeries is noted. The implications of changing the service provided in A & E to accommodate or deter patients with primary care problems are discussed.