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hi everyone Dr Byron here Clinical Director for shape Primary Care Network and clinical lead for barani group practices now today I want to share with you some exciting work weve been doing in order to reduce the number of people in a e and really understand why people attend a e in first place now historically nationally as a primary care team weve done lots of work to really reduce the number of patients having to attend a e we put GPS and various types of clinicians in the a e Department who can help with patients who are more suited towards primary care and triage patients for alternative clinical pathways weve also done lots of post admission work in order to understand why people attend a e and develop alternative clinical pathways for the future unfortunately over time the things that weve been doing have had limited effect weve also made some big assumptions weve assumed people attend a e because they cant wait for their GP or dont want to wait for their GP or cant con