As many as 6.5 million patients visiting accident and emergency (A&E) departments every year should be getting treated elsewhere in the healthcare system, according to the doctor in charge of revamping emergency services in England.
Speaking to SKY News, Professor Keith Willett, the national director for Acute Episodes of Care, said the huge strain on A&E services across the country could be relieved if this crop of patients were treated by GPs, pharmacists and even ambulance workers instead.
Giving a glimpse of what reform in the emergency services may entail, Willet reportedly noted that A&E departments are having to deal with routine medical problems because patients are unable to get an appointment with their family doctor quickly enough, and stressed “we can look at the way primary care is available to people”.
“By changing the way we deliver services we can start to address the demand. We can do the same thing in terms of the ambulance services and how much, how many patients they treat, at the scene, rather than transfer and that’s about them having the right information,” he told the broadcaster.
But his comments have angered RCGP chair Professor Clare Gerada, who said it was “unacceptable to lay the blame at the door of hardworking GPs who are also under huge pressure as we try to manage ever-increasing workloads with diminishing resources”.
“While we don’t begrudge our A&E colleagues the money being poured into the service, this is a short-term sticking plaster,” she said, calling instead for a “long-term investment in general practice – including more GPs – so that we can do more for patients in our communities and prevent people going to hospital apart from when it is absolutely necessary”.
There is fast-growing concern among NHS leaders that urgent and emergency services could buckle under the pressure during the winter months unless steps are taken to address the central issues.
Ageing population and care pathways
In a survey for the NHS Confederation, nearly half of respondents said the key pressure point on A&E services is the ageing population and growing number with multiple long-term conditions, while more than a quarter cited difficulties with discharging patients or transferring them to alternative care settings as the primary issue.
More than half said giving organisations much earlier notice about funding designed to ease winter pressures would be very helpful, while others called for a public information campaign on alternative ways to access unplanned NHS care and treatment, and more incentives for staff to work in A&E.
“Clearly there isn’t one solution to the A&E problem,” said NHS Confed chief Mike Farrar. “There needs to be cultural change in order to introduce seven day a week working in the NHS and social care, and a greater shift of our resources to enhance community services, so patients are treated closer to or in their homes rather than automatically default to A&E when they are ill”.
The Government recently announced its was handing over an extra £500 million to help ease A&E pressures over the next two years.
“A lot of things are happening to give support to the front line,” Health Secretary Jeremy Hunt told SKY News, but also warned “that’s not to say we are not worried about it, because it is going to be very tough, and we understand that.”
Professor Willett and Professor Sir Bruce Keogh, medical director for NHS England, are due to publish their reform of emergency services sometime this autumn.
