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Doctors Warn A&E Must Change – Or Face Collapse

The College of Emergency Medicine and the Foundation Trust Network have proposed drastic and urgent changes to the NHS’s A&E units, and have warned that the system is at risk of collapse, according to a report by the BBC.

Rising demand has left those working in the health service fearful for its future, with the proposals focussing upon funding and staff numbers - two issues which have also been highlighted within the media.

Health Secretary Jeremy Hunt has commented upon the proposals, and stated that it is “very tough out there” and that the government would attempt to aid the changes with a “better joining up” of health and social care.

The NHS in England began to miss its four-hour waiting time target in the winter of 2012, which came as a blow on top of the increase of 50% of A&E attendance growth over the past decade. However, it’s not just the English sector which has faced these pressures as departments in Wales have also seen reports of failures.

The College of Emergency Medicine based their report on feedback given from over half of all A&E units across the United Kingdom, which saw claims of shortages of middle-grade and senior doctors. On top of this, the report also commented upon a need to reduce the amount of attendances by patients with a call for alternatives to free up some of the services time.

Somewhere between 15% - 30% of attendees to A&E do not require the care given by these departments and could be treated in a non-emergency service instead. The Foundation Trust Network complimented this report by suggesting the funding system within the UK seems to punish those A&E services which see a rise in attendances.

The BBCs Health Correspondent Nick Triggle addressed the rise in numbers: “Across the NHS more patients are being seen, but the upward trend is perhaps the greatest in A&E. It is often said that the lack of out-of-hours GP care is the cause of rising demands on A&E.

“That is certainly true. Since 2004 GPs have been able to opt out of providing night and weekend cover, leaving it to agencies provide care.”

As hospitals are only paid 30% of the normal fee when admissions rise above the levels in 2008-09, many hospitals are seeing costs soaring into the millions to rectify the situation. These cuts are an attempt to encourage the NHS to reduce admission numbers, but the system is currently failing to do so.

Shadow health secretary Andy Burnham has said: “Warnings don’t come any more serious than this. Too many hospitals around England are sailing dangerously close to the wind, operating way beyond safe bed occupancy levels.

“The full integration of health and social care [could rectify the situation] – a national health and care service, if you will. As people get older, we’ve got to support them in their homes so they don’t end up in hospital.”

Chris Hopson, chief executive of the Foundation Trust Network, commented: “Unless we can change the funding structure, the A&E system is going to fall over. We simply cannot carry on.

“Unless we can make some really significant changes over the next six months I think it’s pretty clear the system is in danger of falling over next winter.”

The NHS England has agreed to invest some of the savings it makes into the A&E services for a short-term solution, whilst commissioning a full report of emergency care to be led by Sir Bruce Keogh, the medical director.

If you’ve suffered from medical negligence due to A&E waiting times and overcrowding, visit the First4Lawyers medical negligence page for all the information you’ll need to make a claim.

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