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Bid to ease emergency care pressure

The NHS must design a simpler system if it is to relieve pressure on emergency care, according to a new report.

Widespread fragmentation and different names given to urgent care are causing confusion, leading to patients presenting at services which might not best suit their needs, a review had found.

"Urgent care services are characterised by variation and a lack of standardisation and clear information. This contrasts with the strong identity of A&E departments," it said. "Variation in acceptance and quality of care provided can result in delayed treatment or multiple contacts and a poor experience of care, as well as inefficient use of expertise and resources."

Other factors affecting A&E units included variations in access to primary care services leading to many patients attending urgent and emergency care for conditions that could be treated at the GP surgery, the report found.

There is also a variation in the management of patients with long-term conditions by primary care services, it said. Some patients lack confidence in telephone advice and are likely to pursue a second opinion "inappropriately", it added.

Urgent or unplanned care currently leads to at least 100 million NHS calls or visits a year, representing around one third of overall NHS activity and more than half the costs, the report said. Growing numbers of frail, elderly patients and more treatable illnesses are among a range of factors contributing to "ever greater" pressure on health and social care services, it said.

Sir Bruce Keogh, medical director for NHS England, who is leading the review, said better communication could reduce unnecessary demands on A&E services.

"The current concerns around A&E performance should be seen as a stimulus and opportunity to improve the way we offer care between our hospitals, primary and community care and social services," he said in a foreword to the report.

"Better integration and communication between these services could reduce unnecessary attendances at A&E and enable people in hospital to return home sooner. This in turn could free up hospital beds so patients who need admission from A&E would not be kept waiting so long."

A consultation on the findings of the review has been launched.

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