The Royal College of Emergency Medicine (RCEM) and the Patients Association have published a joint report, entitled “Time to Act. Urgent Care and A&E: the Patient Perspective”, which incorporates results of a survey of patients conducted between September 2014 and February 2015.
This report addresses the choices, decisions and experiences of patients who accessed A&E services for urgent healthcare needs. It indicates that patients need better information and signposting about alternative services such as out-of-hours GPs, walk-in centres and the NHS 111. These alternative (non-A&E) services require sufficient capacity and should provide 24/7 availability of access to avoid growing pressures on the over-stretched A&E system.
The co-location of other out-of-hours services with A&E departments appears to be the preferred solution:
“The Patients Association and The Royal College of Emergency Medicine recommend co-location of other out-of-hours services with A&E departments to simplify patient decision-making while ensuring that all patients are streamed to the most appropriate care provider in a safe and timely manner”.
Time to act. urgent care and A&E: the patient perspective. London: Royal College of Emergency Medicine and Patients’ Association, [May 2015] June 1st 2015.
Possibly also of interest, is a Nuffield Trust analysis of the main causes behind the pressures on accident and emergency departments:
Blunt, I. Edwards, N. [and] Merry, L. (2015). What’s Behind the A&E Crisis? London: Nuffield Trust, March 2015. Policy Briefing No.3.
Further Selected References Relating to Co-Location of Alternative Out-Of-Hours Services With A&E Departments
On the potential roles GPs in the planning and provision of services out-of-hours:
Could GPs be more involved in out-of-hours planning and provision? The Future of GP Out of Hours Care: Royal College of General Practitioners (RCGP), 24th February 2015. London: NHS Confederation, March 10th 2015.
A Scottish review of out-of-hours primary care services and new approaches to unscheduled care, building on the Scottish Government’s 2020 Vision for the NHS:
Review of out-of-hours primary care. The Scottish Government: January 30th 2015.
An earlier follow-up survey concerning recommendations from the Royal College of Emergency Medicine:
Ignoring the prescription. London: Royal College of Emergency Medicine, March 2015.
Mental Health Crisis Care: Care Quality Commission Report
The CQC has produced an extensive report which touches upon the experiences of patients attending A&E departments for help in mental health crises. More information on the CQC’s “Right here, right now” national review is available.
Ruling-Out Suspected Heart Attacks
Aside; a promising new troponin test has potential to reduce hospital admissions for chest pain in future:
Gallagher, J. (2015). New heart attack test ‘cuts A&E visits’. London: BBC Health News, October 7th 2015.