Table 6.

Arguments proposed for the potential impact embedding GPs in ED teams

	Integrating GPs as part of the ED team
Potential impact	Positive	Negative	Exemplar quote
Training and clinical skills	Benefits for improving team working and skill mix. Training and educational benefits for junior doctors and GPs.	GPs may lack appropriate skills/experience to work in ED	‘Yes, knowledge and experience. GPs could teach about headaches to the primary care nurse and us, if we wanted to help out a little bit, to bring on new nurses who are coming through and learn. Then you could develop majors practitioners, bring them through. Do teaching and education, bring minors and- it would be a perfect bed of opportunity’. (Rowan, staff interview, 20)
Deskilling of GP and nursing workforce	Nurses prefer to work in GPED	Integrating GPs may cause deskilling. Negative views on streaming and the potential for GPED to deskill the nursing workforce by diverting minor illnesses to GPED.	‘There’s a risk that the GPs who are then working on a consistent basis within an emergency department or as part of… that they can go native within that setting and actually take on more of the, qualities that you might expect to see, in other emergency department staff and actually lose the characteristics that you might expect to see of a GP’. (Service leader interview, 10)

ED, emergency department; GP, general practice; GPED, GPs working in or alongside the ED.