Dr Michael Dixon, Chair, NHS Alliance says:
“Pressures facing A&E departments across the country are not new and should not be used as ammunition by political parties – but recognised as a long term problem which has not been adequately addressed in the face of a changing and ageing population with complex health needs.
“Reports* from the frontline suggest workloads for out of hours services are hovering around 20% – 30% above expected volumes this winter.
“The real issue behind the reported crisis is how and where patients seek and get treatment across the many and varied primary care options available to them. There is still a concern in some areas about how patients get information about where to go for medical treatment.
Non-clinical NHS 111 advisors direct patients with minor ailments and conditions to out of hours services, while patients with more pressing and urgent health concerns which should be treated by primary care practitioners, are forced into ambulances and A&E.
“The cycle continues resulting in angry patients in the wrong place at the wrong time for the treatment needed. Frustrated primary care clinicians are doing the best they can, but unless all the options available to patients are made accessible and used, the crisis cycle will go on.
All parts of the system need improvement. Although GPs, urgent care and out of hours services are coping remarkably well given the pressures they are facing, our members are rightly concerned that this continued pressure will put patients at risk.
“General practice needs to work on offering consistent and rapid appointments for patients – some do this well, others fall short. More patients with minor ailments, colds, flus, and long term conditions could be helped by community pharmacists if nationally commissioned programmes were implemented. This could drastically reduce pressure on GPs and in turn, A&E. Health and social care systems need to become seamless, working quicker on plans to find local solutions ensuring patients who no longer need beds can be discharged from hospital.
“The system has become too fragmented and complicated and while there is no one size fits all solution a few critical actions could make the system more robust, patient friendly and practitioner led:
- Immediate review of NHS 111 – our members tell us that in many areas it’s not working and more importantly, it is putting patients at risk.
- Review culture of target setting: are current targets realistic and reflective of effective clinical outcomes for patients
- Intelligent clinical triaging of patients so they are sent to the right place, at the right time
- More support to deliver flexible local solutions to meet the needs of the local community driven by general practice, out of hours services and all out of hospital care working together to build patient confidence in an integrated primary care service.
Notes to Editors
NHS Alliance is the leading independent voice for primary care, bringing together patients, frontline staff, providers and commissioners bound the common values of the NHS. Its core purpose is to work collaboratively to improve health care within a sustainable NHS, facilitating new and better ways of delivering services through its networks and campaigns. It welcomes patient-focused organisations and individuals of all disciplines, representing them to government and its agencies to influence policy in the interests of all its members.
*Anecdotal evidence from NHS Alliance members and Urgent Health UK suggest that UK indicate workload figures this winter have consistently been between 20% – 30% above predicted volumes.
