22.07.13
Focus on primary care to save ‘unsustainable’ A&E departments
London trusts are working to develop Recovery and Improvement Plans in response to rising emergency and urgent care pressures, which can even lead to preventable deaths.
At an event led by NHS England, health professionals came together to plan how urgent and emergency care could be improved. Improving primary care was identified as key, and better out-of-hospital care could reduce the strain on struggling A&E departments.
Anne Rainsberry, regional director for NHS England (London), said: “The current system of providing emergency and urgent care in hospital A&E departments to everyone is unsustainable. We need new ways to ensure that people are seen quickly, by the professional best suited to deliver the right care. In most cases this means that patients should receive more appropriate care in community settings rather than attending hospitals.
“Our aspiration is that all patients receive joined up care wherever they live in London. This means that acute care, including A&E and ambulance services, social care, community care and primary care work together to ensure that patients have a seamless journey from start to finish.
“We should also have very high aspirations for the timeliness in which people receive care from community professionals. We know that some patients attend A&E departments because they know they will be seen and treated within four hours.
“We also think there is a link between satisfaction with your GP and use of A&E. The happier people are with access to their GP, the less people use A&E (and vice versa) and in London, access to a GP is not as good as elsewhere in the country.”
Dr Andy Mitchell, medical director for NHS England (London) said: “All the facts tell us that without reform people will continue to experience unacceptable delays that in some cases lead to preventable death. Its vital that the work the NHS has done to develop local Recovery & Improvement Plans is not just a paper exercise and that we will use them to start shaping better services in primary and community care settings. Most clinicians acknowledge the system is unsustainable and that it’s our job to deliver better options for our patients.
“The largest group of the population visiting A&E in London are 20-29 year olds (19%) and the second largest group are 30 – 39 year olds (15%). These people, in the main, are making an active decision to go to A&E because they know they will be seen and treated by a doctor within four hours.
“They are also the biggest group to leave A&E with no investigations and no significant treatments (27%). The percentage of people leaving with no investigations and no treatment falls with age.
“This age group expects high quality services on demand and they are used to being consumers and getting what they want, when they want it. We have to change the NHS so that it’s much faster and more convenient to see a GP and in doing so we will decrease the pressures on emergency and urgent care.”
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