Introduction
Several studies have demonstrated that 25-40% of Accident and Emergency (A&E) department attendances are for conditions that could be managed by the patient's general practitioner. The number of these who could be appropriately managed by a community pharmacist has not previously been established.

Aim
To establish the frequency with which patients attend the A&E department of St. Thomas' Hospital with problems that could be managed by a community pharmacist.

Methods
A cross-sectional, retrospective review of A&E records for adult patients (>16 years) was conducted during the first two weeks of March 1999. Using recognised criteria, patients suitable for 'Primary Care' management and/or patients presenting with 'Drug Related Problems' were identified. From these groups, those patients who would be appropriate for community pharmacist management were further classified. Data was collected using a form suitable for scanning into a Microsoft Access database and validated by appropriate personnel using the same criteria. Results were analysed on an intention to treat basis. Appropriate statistical analysis was applied.

Results
During the study period 2636 adult patients attended the A&E department of St. Thomas' Hospital. Results were calculated on an 'intention-to-treat' basis demonstrated that management by a pharmacist was considered possible in 8% of attendances (95% CI 6.8-8.9). The most commonly presented conditions were in the category of 'Upper Respiratory', 'Gastrointestinal' and 'Pain'. The range of symptoms presented reflected those previously recognised in the literature.

Conclusion
A pharmacist could manage an estimated 8% of adult attendances at St. Thomas' A&E department. The opportunity to extend the role of the pharmacist within the A&E department should be explored.