With pressures on accident and emergency departments hitting the headlines recently, John Appleby, Chief Economist at The King’s Fund, looks at the facts behind A&E attendances and waiting times.
John Appleby: pressures on accident and emergency services
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If you can't get through to your GP (how many have proper telephone queuing systems), if they do not open their surgery in off peak hours, (a couple of hours on a Saturday and one commuter clinic a week just won't cut it) if they do not work with other providers to take chargeof the design, monitoring and care systems for their LTC and EoL patients. Get involvedand stop whining about your busy caseloads. Instead be radicall think about what your patients need not what traditionally you have provided.
As part of their policy decision, they started reducing manning in NHS Direct and by 2012/13, had reduced it from 2576 in 2009/10 to 1597 in 2012/13, a reduction of 38%. It resulted in a substantial reduction in the numbers 'treated' with the numbers referred to A&E rising to about 36%.
The first consequence of this was to increase referrals to A&E by about 438K patients.
With the new 111 service predominately working with a 'cheaper' staff mix-ie more call handlers and fewer nurses/doctors, and may patients self referring themselves directly to A&E because of lack of 111 service,
compared to 2009/10, there would have been an extra 296K extra referrals to A&E.
So, in 2012/13, there would have been an extra 734K patients attending our A&E departments. This largely explains the problem of extra workloads in our A&E.
So, this problem has been created by this government and not anybody else. If the policy to dismantle NHS Direct is reversed, within a short period, this problem can be resolved.
Add this to an ageing population, reduction in nurses in the thousands, increased social/population mobility, reduction in service provided by GP's, socio-economic factors and financial decline then the real story emerges.
The problem will not be solved by simply re-instating NHS direct, although I do fundamentally disagree that ANY medical advice or management can be given by clerical staff with no experience of health care and by following a script. It is a catastrophic decision to use this approach and should be reversed urgently.
very professionally done. The sticking point for us was the blood results we had to wait many hours. If this could have been done by a section just for A&E, rather than for all the hospital needs. i feel a lot of people would be able to go home earlier, freeing up trolly beds. For those who show not signs within the blood of anything, that could be treated by a stay in the hospital. We found that services for help at home came to the hospital to assist us, was a great feeling of support.
How can the NHS stop wasting money in this way?
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