Out-of-hours general practice care in Ireland: Consultations and emergency department referrals from 2013 to 2022

BACKGROUND: General Practitioner (GP) out-of-hours (OOH) co-operatives provide urgent primary care across the Republic of Ireland, but national workload trends and hospital referral patterns are poorly described. AIM: To quantify OOH activity (2013-2022), examine for changes in OOH service utilisation over time , and describe emergency department (ED) referral rates. DESIGN & SETTING: Retrospective observational study using aggregated electronic medical record (EMR) data from eight large GP OOH co-operatives across the Republic of Ireland, 2013-2022. METHOD: Annual measures included total consultations and consultation type (triage-nurse versus GP consultation; teleconsultation, treatment-centre visit, home visit). Subsets provided age mix and ED referral data. Descriptive analyses were contextualised with nationally available open data and prior literature. RESULTS: Across 2013-2022, participating OOH services recorded approximately 0.9 million consultations annually, with an overall 26% rise in consultations over the 10 year period. Two major inflection points were observed: introduction of free GP care for under-6s (2015) was followed by a 17% rise in consultations (2014-2016), whereas COVID-19 coincided with an 18% fall in consultation volume and fewer face-to-face visits (2020-2022). ED referral rates remained broadly stable at~13% throughout. CONCLUSION: OOH GP co-operatives provide substantial, adaptive capacity- managing the vast majority of patients within primary care. This study supports the view that OOH co-operatives act as a buffer for EDs and a pressure-release valve for daytime general practice. Routinely collected EMR data can track OOH activity over time and should inform workforce and service planning.