{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T02:27:14Z","timestamp":1793672834788,"version":"4.5.1"},"reference-count":25,"publisher":"Royal College of General Practitioners","license":[{"start":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T00:00:00Z","timestamp":1549929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Gen Pract"],"accepted":{"date-parts":[[2026,7,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Demand on emergency healthcare services is increasing. Utilising GPs in emergency ambulance services (EASs) may be effective at reducing avoidable conveyances to emergency departments and releasing emergency ambulances for high-acuity cases. There is limited evidence on models of GP EAS roles in the UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To describe the current provision of GP EAS roles and to develop a provisional explanatory programme theory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design &amp; setting<\/jats:title>\n                    <jats:p>Qualitative realist interview study involving professionals with detailed knowledge and experience of GPs working in EASs across the UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Potential participants were identified and approached by research and development teams at ambulance trusts. Interviews were semi-structured, with questions developed, piloted, and refined by the research team. Interviews were conducted online with 27 participants, with a realist approach taken to data analysis to explore the mechanisms by which GP EAS roles produce their intended outcomes in different contexts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The GP role is predominantly to undertake enhanced remote patient assessment following an initial algorithmic triage, aiming to provide the most appropriate level of care. While optimising the clinical response to individual callers, this also serves a system-level function by protecting ambulance resources to support timely responses to high-acuity patients. The mechanism behind GP triage was explored through existing middle-range theories around risk individualisation \u2014 the process of translating organisational risk appetite to individual patient contacts. This helps the ambulance service to make \u2018braver\u2019 decisions, namely, those involving non-conveyance, alternatives to conveyance, or lower-acuity responses. GPs do this effectively due to their seniority, broad clinical knowledge and experience, approach to risk and uncertainty, ability to practise outside guidelines, consultation and communication skills, and system awareness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>GPs in EASs serve both individual patients and the system by individualising organisational approaches to risk and resource management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3399\/bjgp.2026.0105","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T19:15:16Z","timestamp":1785525316000},"page":"BJGP.2026.0105","source":"Crossref","is-referenced-by-count":0,"title":["GP roles in emergency ambulance services in the UK: a qualitative realist study"],"prefix":"10.3399","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0800-3452","authenticated-orcid":false,"given":"Alex","family":"Burrell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6680-9887","authenticated-orcid":false,"given":"Matthew","family":"Booker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1987","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"2026110217501021000_BJGP.2026.0105v2.1","unstructured":"Hearnshaw S (2025) Quarterly national ambulance data report: demand, response and hospital handover data to the end of December 2025. accessed. https:\/\/aace.org.uk\/wp-content\/uploads\/2026\/01\/National-Ambulance-Data-Full-Data-to-December-2025.pdf. 28 Oct 2026."},{"key":"2026110217501021000_BJGP.2026.0105v2.2","unstructured":"Department of Health and Social Care NHS England (2025) Urgent and emergency care plan 2025\/26. accessed. https:\/\/www.england.nhs.uk\/wp-content\/uploads\/2025\/06\/Urgent-and-emergency-care-plan-2025-26.pdf. 28 Oct 2026."},{"key":"2026110217501021000_BJGP.2026.0105v2.3","unstructured":"NHS England (2013) High quality care for all, now and for future generations: transforming urgent and emergency care services in England. The evidence base from the Urgent and Emergency Care Review. accessed. https:\/\/www.england.nhs.uk\/wp-content\/uploads\/2013\/06\/urg-emerg-care-ev-bse.pdf. 28 Oct 2026."},{"key":"2026110217501021000_BJGP.2026.0105v2.4","unstructured":"UK Government (2025) Fit for the future: 10 year health plan for England. accessed. https:\/\/assets.publishing.service.gov.uk\/media\/6888a0b1a11f859994409147\/fit-for-the-future-10-year-health-plan-for-england.pdf. 28 Oct 2026."},{"key":"2026110217501021000_BJGP.2026.0105v2.5","unstructured":"Scottish Government (2025) Health & Social Care Service renewal framework 2025\u20132035. accessed. https:\/\/www.gov.scot\/binaries\/content\/documents\/govscot\/publications\/strategy-plan\/2025\/06\/health-social-care-service-renewal-framework\/documents\/health-social-care-service-renewal-framework\/health-social-care-service-renewal-framework\/govscot%3Adocument\/health-social-care-service-renewal-framework.pdf. 28 Oct 2026."},{"key":"2026110217501021000_BJGP.2026.0105v2.6","unstructured":"Welsh Government (2021) A healthier Wales: our plan for health and social care, accessed. https:\/\/www.gov.wales\/sites\/default\/files\/publications\/2021-09\/a-healthier-wales-our-plan-for-health-and-social-care.pdf. 28 Oct 2026."},{"key":"2026110217501021000_BJGP.2026.0105v2.7","unstructured":"Department of Health Northern Ireland (2016) Health and wellbeing 2026: delivering together. accessed. https:\/\/www.health-ni.gov.uk\/sites\/default\/files\/publications\/health\/health-and-wellbeing-2026-delivering-together.pdf. 28 Oct 2026."},{"key":"2026110217501021000_BJGP.2026.0105v2.8","doi-asserted-by":"publisher","DOI":"10.3399\/BJGPO.2023.0002"},{"key":"2026110217501021000_BJGP.2026.0105v2.9","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"2026110217501021000_BJGP.2026.0105v2.10","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-016-0643-1"},{"key":"2026110217501021000_BJGP.2026.0105v2.11","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n2061"},{"key":"2026110217501021000_BJGP.2026.0105v2.12","doi-asserted-by":"publisher","DOI":"10.5465\/annals.2018.0110"},{"key":"2026110217501021000_BJGP.2026.0105v2.13","doi-asserted-by":"publisher","DOI":"10.1101\/2025.07.14.25331501"},{"key":"2026110217501021000_BJGP.2026.0105v2.14","unstructured":"Pawson R Tilley N (1997) Realistic evaluation (Sage Publications, London)."},{"key":"2026110217501021000_BJGP.2026.0105v2.15","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.56189"},{"key":"2026110217501021000_BJGP.2026.0105v2.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2008.04.031"},{"key":"2026110217501021000_BJGP.2026.0105v2.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2009.03.019"},{"key":"2026110217501021000_BJGP.2026.0105v2.18","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.29521"},{"key":"2026110217501021000_BJGP.2026.0105v2.19","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2000.04079.x"},{"issue":"1","key":"2026110217501021000_BJGP.2026.0105v2.20","first-page":"12","article-title":"Risk aversion and costs: a comparison of family physicians and general internists","volume":"49","author":"Fiscella","year":"2000","journal-title":"J Fam Pract"},{"key":"2026110217501021000_BJGP.2026.0105v2.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2024.108232"},{"key":"2026110217501021000_BJGP.2026.0105v2.22","doi-asserted-by":"publisher","DOI":"10.3310\/HEPB9808"},{"key":"2026110217501021000_BJGP.2026.0105v2.23","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-021-02019-z"},{"key":"2026110217501021000_BJGP.2026.0105v2.24","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-025-03863-z"},{"key":"2026110217501021000_BJGP.2026.0105v2.25","doi-asserted-by":"publisher","DOI":"10.3310\/GTJJ3104"}],"container-title":["British Journal of General Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.3399\/BJGP.2026.0105","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T01:50:22Z","timestamp":1793670622000},"score":1,"resource":{"primary":{"URL":"http:\/\/bjgp.org\/lookup\/doi\/10.3399\/BJGP.2026.0105"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,31]]},"references-count":25,"alternative-id":["10.3399\/BJGP.2026.0105"],"URL":"https:\/\/doi.org\/10.3399\/bjgp.2026.0105","relation":{},"ISSN":["0960-1643","1478-5242"],"issn-type":[{"value":"0960-1643","type":"print"},{"value":"1478-5242","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,31]]}}}