There is little evidence to support locating primary care services in emergency departments (EDs) because the costs involved would outweigh the savings, a review has concluded. Rising numbers of patients seeking emergency care have prompted some UK hospitals to co-locate primary care doctors and nurses in EDs. Although co-location is said to be implemented ‘at significant cost’, there has been little evaluation of its effectiveness. An understanding of the profile of patients who need primary care when attending EDs is ‘fundamental to forecasting the resources and cost,’ says the researcher. In total, 20 studies between 1980 and 2015 were reviewed, assessing the impact on demand, outcomes, patient satisfaction and cost effectiveness. The review found an increase in demand for emergency care services leading to the conclusion that once a facility is built, it will be overused. In addition, if co-located services are not available around the clock, patients will turn to emergency care, particularly out-of-hours care, he says. Diverting patients to primary care services did not save money because the costs to set up and maintain the service dwarfed any savings. The change to services also risked increasing staff dissatisfaction. Overall, the review found little evidence of an improvement in crowding or throughput by streaming primary care patients out of emergency care. Burke D (2016) Primary care services located with EDs: a review of effectiveness. Emergency Medicine Journal. doi:10.1136/emermed-2015-204900.