The Royal College of Emergency Medicine (RCEM) has proposed that the A&E brand has such a dominant and ingrained persistence in the minds of the public that it might be futile to try persuading people not to make unnecessary trips to A&E. The reverse approach is being suggested instead. Around 40% of A&E departments have explored co-locating GP care already. The RCEM recommends pursing this trend further, by co-locating mental health crisis care, emergency dental care and pharmacy services with A&E departments.
Stretching the A&E brand in this way could remove barriers to accessing appropriate urgent care quickly, instead of setting-up fragmented services which tend to increase patient confusion and / or receive disappointing public-uptake.
Triggle, N. (2015). Could the NHS learn from Virgin, Apple and co? London: BBC Health News, October 2nd 2015.
This relates to:
Full Text Link (Note: This article requires a suitable Athens password, a journal subscription or payment for access).
Hawkes, N. (2015). Emergency departments should provide a range of out-of-hours services, conference hears. BMJ. September 23rd 2015; 351: h5080.
The Facts about A&E. [Online]: Royal College of Emergency Medicine (RCEM), June 3rd 2015.
Exit Block – what it is and what needs to be done about it. [Online]: Royal College of Emergency Medicine (RCEM), September 3rd 2015.
Exit Block in Emergency Departments: what it is and why it is dangerous. [Online]: Royal College of Emergency Medicine (RCEM), September 9th 2015.
The A&E ‘Brand’. [Online]: Royal College of Emergency Medicine (RCEM), September 22nd 2015.
Putting the Pieces Together (RCP)
Coming from a slightly different direction, a recent Royal College of Physicians (RCP) report discusses the fragmentation experienced by patients when deciding how to approach NHS services. Examples of how commissioners, service planners and clinicians can collaborative on improving patient care are suggested.
Putting the pieces together: removing the barriers to excellent patient care. London: Royal College of Physicians (RCP), September 8th 2015.
There is also an executive summary:
How physicians can influence the commissioning system: a guide to getting involved. London: Royal College of Physicians (RCP), September 8th 2015.
Demographic Aside: Socioeconomic Deprivation and Accident and Emergency Attendances
A study of demand for A&E during 2011-2012 found higher demand to be concentrated in areas of high deprivation. Demographic characteristics appear to be the most significant predictors of A&E attendance rates, so other factors less amenable to change could presumably be of lower importance in determining / modifying A&E attendance rates.
Scantlebury, R. Rowlands, G. [and] Durbaba, S. [et al] (2015). Socioeconomic deprivation and accident and emergency attendances: cross-sectional analysis of general practices in England. The British Journal of General Practice: the Journal of the Royal College of General Practitioners. October 2015; 65(639): e649-54.