A&E crisis - again
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News reports on the Health Select Committee Report on Urgent and Emergency Care do not augur well for this forthcoming winter, particularly when some emergency departments were reportedly struggling during the recent hot spell.
In its report, the Committee highlights the desperate levels of staffing in A&E.
Only 17% of emergency departments managing to provide 16 hour consultant cover during the working week. Consultant cover at weekends is worse. The Committee highlights the need to ensure that emergency medicine is professionally and personally rewarding. They make an interesting point about the problem of patient flow within hospitals with evidence suggesting that assessment and reassessment of patients by junior staff in emergency departments or medical assessment units breeds duplication and delays.
This is something that is relevant in much of the work that we do in our team whereby patients are often seen by a multitude of juniors but not seen by a senior doctor or referred for treatment until it is too late.
The Committee rightly points out that the availability of consultants in these areas is key to ensure that patients are reviewed at an early stage. The Committee believes that the current configuration of NHS 111 will not assist in keeping people from inappropriately attending A&E and NHS England needs to consider the balance between triage and clinical assessment.
They also focus on the needs of elderly patients, who often end up in A&E without any real need for that sort of treatment. The Committee recommends the introduction of a new model of integrated primary care to address the out of hours care and the relationships between social services and others. It will be interesting to see how the Department of Health and NHS England respond to this report and let's hope they respond quickly.
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