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Waiting for A&E care

Accident & Emergency; we can’t live without it but it appears that increasingly we are having to be patient if we have need of its services. So much so that research carried out by the BBC has revealed that in the past year three million A&E attendees had to wait in excess of four hours in order to be treated.

To put that in context, nearly twenty-four million people were treated or admitted within the four hour time band. Or to put it another way, if each A&E attendee visited once then 41% of the UK’s population stepped through the A&E doors in just one year. It’s hardly surprising therefore that the president of the Royal College of Emergency Medicine, Dr Taj Hassan, commented to the BBC that the A&E system had been “stretched to its very limits.”

Accepting that the answer probably isn’t going to come from finding the money required to set up and staff an additional twenty A&E units, health services across the UK are looking to new ways of coping with demand; adopting a variety of methods in order to reduce footfall and speed up throughput. Whilst the Department of Health has turned aside suggestions that patients should be required to receive a referral from their doctor or NHS 111 before visiting A&E, it is true that just 20% of those attending A&E have first tried to access health advice via the 111 service. Perhaps if they had sought alternative advice either from 111 or their local pharmacy they would not have resorted to A&E for help with broken false fingernails, splinters in finger, paper cuts or shaving cuts; all of which featured in the 2016 top ten list of inappropriate trips to A&E in Cambridgeshire.

It’s hardly surprising therefore that a number of health trusts have been launching awareness campaigns in a bid to educate people on A&E alternatives including one video from NHS Wakefield Clinical Commissioning Group set to the tune of the 12 days of Christmas. Inappropriate visits aside, health authorities are also working to free up beds in order to speed up treatment times. Measures here include partnering with care homes and other health care professionals in order to deliver more health care in the community.

Undoubtedly this will put additional pressure on external health care services but perhaps it will also help to ensure that treatment is available at the most appropriate point of contact. For example, another on the Cambridgeshire inappropriate visit list was an individual who had suffered months of back pain without calling on the services of a health professional. Had they been given access to a physiotherapy service they could have saved themselves months of pain and saved the A&E department from having to assess their needs.

The winter flu season is not yet upon us and that will undoubtedly bring further challenges for A&E departments as will an increase in demand for treatment of strains and sprains as a result of icy conditions. Many of these conditions can be treated equally well by health providers such as pharmacists, physiotherapists or chiropractors. We’ve already seen pharmacists take up the strain in respect of flu jabs; perhaps this is the start of a wider acceptance of alternative providers helping to deliver health care in the UK.



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