Our written submission to the House of Commons Health Select Committee inquiry into emergency services and emergency care.
The submission considered the future shape of emergency care as demand for accident and emergency (A&E) services rises and financial pressures grow. It presented evidence of deteriorating recent performance on a number of important indicators, including the four-hour wait for A&E and ambulance handover targets.
It found that, while A&E demand had risen considerably over the past 15 years or so, nearly all of this was attributable to increasing activity in new types of centre; and that for the past two and a half years growth had slowed considerably. But it reported multiple, complex causes of pressure on A&E, caused by long-term issues across the health and care system.
The submission raised concerns that the fragmentation of commissioning and lack of strategic responsibility could make system-wide change more difficult to implement. The submission called for more strategic approaches to reduce the complexity of the system for patients, with leadership across the whole system rather than attempted individual fixes. Our recommended solutions included reshaped primary care and chronic disease management; support for patients in their own homes and in care homes; and the provision of flexible and timely community services to allow rapid patients discharge from hospital.