A review led by NHS Medical Director, Professor Sir Bruce Keogh, has reported that the NHS in England needs to provide a much simpler and co-ordinated system of round-the-clock urgent care.
Review of Emergency Care
The review was announced in January this year and its reported aim was to develop a national framework to build a safe, more efficient system, 24 hours a day, seven days a week.
According to the review, which was published this week, urgent or unplanned care leads to around 100 million NHS calls or visits each year and it warns that many patients do not know who to go to when they need urgent medical help. This results in them often going to A&E units, which may not be the most suitable course of action for their needs.
Professor Sir Bruce Keogh was asked to look at the issues by the NHS Commissioning Board following concerns about A&E care and GP out-of-hours services. The review considered urgent and emergency care, including walk-in centres, telephone advice lines and minor injury centres and concluded that there was pressure throughout the system.
The key issue identified in the review is “fragmentation and variation” in services. This creates confusion in patients who are likely to then go to A&E because they know that it will be open and will offer a full range of care.
Professor Sir Bruce Keogh was reported as saying:
“The Urgent and Emergency Care Review has provided us with an excellent opportunity to improve the way we offer care between our hospitals, primary and community care and social services.
“We have seen clear improvement in A&E performance across the country coming into the summer, but the issues will not just simply go away.
“Over the past few months, we have been building an evidence base of guidance, reports and data to inform our review – and it is clear that the way we currently deliver urgent and emergency care needs to change.
“A compelling case for change can only be built on evidence and, while not always comfortable reading, it is the only way to have a truly honest discussion. We must keep pace with medical progress and make sure everyone has the best chance of receiving the most appropriate care.”
Now the review has been published, NHS England is asking patients, public and NHS staff to help shape the future of urgent and emergency care services. Those using and working in the NHS have from 17 June to 11 August to feedback on an evidence base for change and emerging principles that will guide the Review.
The Review Steering Group is chaired by Professor Keith Willett, National Director for Domain Three: Acute Episodes of Care, with representation from professional bodies, a patient and public organisation, providers and commissioning organisations.
Professor Keith Willett, was reported as saying:
“At its heart, this review is about bringing together the expertise from across the health and care system to determine how best to organise emergency care in future.
“We know that A&E is the pinch point of the health and care system and that staff are working very hard to provide the care they know the public need.
“To relieve the pressure and design a system that is sustainable and fit to meet future challenges, we need as many patients, doctors, nurses and NHS colleagues as possible to get involved.”
The Urgent and Emergency Care Review will develop a national framework and associated guidance for clinical commissioning groups in 2015/16 to help them commission consistent, high quality urgent and emergency care services across the country within the resources available.
It seems clear that public awareness of the various services and best routes to obtain care needs to be increased and that this could be achieved through greater continuity and simplicity. It is important to ensure that patients have confidence in the vital urgent care system and it will be interesting to see how the public input in the review will shape the future of care.
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