The A&E crisis is not about hospital staff and money – we must focus on the causes

Top of the news today is the ‘A&E crisis’. Before you get really worried, this ‘crisis’ is based on hospitals that are not meeting the 4 hour target. The system is NOT close to collapse. However, the solutions being put forward to solve this crisis are short term and not sustainable.

It’s essential we focus on the causes of rising attendance, not simply think that a sticking plaster of money and staff is the solution. The causes include poor patient and practice management by GPs, an increase in complex elderly patients, unresponsive social services and people who get drunk.

Pro-active GPs have shown that if they evaluate their patient calls in the morning, then the majority of patients can have their needs met without even going to see the GP. Some have employed community based doctors who can make home visits quickly to sort out patients problems before they become an emergency. Other GPs have examined their patient records and worked out which patients need extra management to help reduce the chances of a crisis in the future. In all cases A&E attendance has dropped dramatically.

The other issue is personal responsibility. During the week about 30% of attendance is due to people being drunk; at the weekend this can rise to 70%. We have to start fining people who abuse the system in this way.

We need to take a long term view of how we manage the complex elderly patient differently with a more multidisciplinary model across social and primary care, and not through A&E. Trauma patients should be dealt with by specialist centres not in your average local A&E department.

In the past hospitals have spent a lot of time and money trying to sort out their A&E problems, but because hospitals are just at the receiving end, nothing sustainable has been put in to place. Over all these are short term measures to get us over the next 12 months. The answer is to solve the problem of rising attendances. We cannot go on increasing staff and money.

About Julia Manning

Julia is a social pioneer, writer and campaigner. She studied visual science at City University and became a member of the College of Optometrists in 1991, later specialising in visual impairment and diabetes. During her career in optometry, she lectured at City University, was a visiting clinician at the Royal Free Hospital and worked with Primary Care Trusts. She ran a domiciliary practice across south London and was a Director of the UK Institute of Optometry. Julia formed 20/20Health in 2006. Becoming an expert in digital health solutions, she led on the NHS–USA Veterans’ Health Digital Health Exchange Programme and was co-founder of the Health Tech and You Awards with Axa PPP and the Design Museum. Her research interests are now in harnessing digital to improve personal health, and she is a PhD candidate in Human Computer Interaction (HCI) at UCL. She is also dedicated to creating a sustainable Whole School Wellbeing Community model for schools that builds relationships, discovers assets and develops life skills. She is a member of the Royal Society of Medicine’s Digital Health Council. Julia has shared 2020health's research widely in the media (BBC News, ITV, Channel 5 News, BBC 1′s The Big Questions & Victoria Derbyshire, BBC Radio 4 Today, PM and Woman's Hour, LBC) and has taken part in debates and contributed to BBC’s Newsnight, Panorama, You and Yours and ITV’s The Week.
This entry was posted in Alcohol, Elderly, Jeremy Hunt and tagged , , , , , , . Bookmark the permalink.

Leave a Reply

Please log in using one of these methods to post your comment:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s