In the study by Salford University for Sefton health authority, the research team used quantitative and qualitative methods to explore the research questions and adopted retrospective and prospective approaches.

They interviewed general practice managers, A&E department managers and nursing home matrons to clarify the problem. The interviews were followed by a seven-month retrospective census questionnaire to identify the level of, and reasons for, referrals from all nursing homes to GPs and A&E departments.

A separate, three-month concurrent data collection, with a random sample of 12 nursing homes, was carried out of all emergency/unplanned referrals. Finally, through interviews with nursing home matrons, residents and GPs, the team explored perceptions of the appropriateness of referrals.