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.