The emergency bed service in London--who uses it?

As part of wider review, this study examines the pattern of referrals to the emergency bed service from seven selected health districts in London over a six-month period. A 12-fold variation in the use of the emergency bed service was found between the different districts. Half the referrals to the service were made by doctors working in deputizing services, less than 1% of referrals were due to inter-hospital transfers and half the referrals were made by general practitioners. A few general practitioners were high users: 46% of the general practitioner referrals were accounted for by only 5% of the practitioners.The second part of the study concerned a questionnaire survey of a sample of general practitioners in the seven health districts (n = 963) and an 83% response rate was achieved. Almost three-quarters of the respondents did not use the emergency bed service. Wide variation between the different health districts was again demonstrated. In spite of the variations described, the survey revealed a continuing demand for the service by general practitioners.