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DEC 16/2013

Taking the pressure off A&E departments: an NHS priority

Over the coming months, healthcare professionals will observe a number of initiatives being enacted across the medical sector, aimed at relieving some of the pressure on accident & emergency (A&E) departments within the NHS.

A&E is one of the most essential services offered by the NHS, playing a crucial role in saving the lives of those in the most pressing and dire need of treatment. However, while the quality of A&E care remains generally high, there is evidence that many departments have become overburdened in recent times, prompting the NHS to take action.

The rapid rise of emergency department attendance
Recent figures from the Health and Social Care Information Centre (HSCIC) have highlighted the scale and ongoing development of the current problem. According to its data, A&E departments dealt with 21.7 million attendances overall during 2012-13 - an average of 60,000 patients a day.

This is an 11 per cent increase on four years ago and compares to a 3.2 per cent growth in the England population during the same period. Attendances at A&E tended to peak slightly in the April-to-June quarter of each year, with the majority of visits coming between work hours of 09:00 to 18:00.

Tellingly, of every 20 attendees, 13 refer themselves to A&E, while only one is referred by a GP. The figures also revealed that about one-third of patients leave A&E having received guidance or advice only.

It can be inferred from these statistics that many of the people attending emergency departments do not necessarily require urgent care, but are doing so because they are unaware of other services available to them, or are unable to access any other forms of medical care.

This can lead to many A&E departments often being full or close to capacity, leading to long waiting times and a reduction in the quality of patients' experiences.

Service expansion - a potential solution
With a particularly harsh winter expected in 2013-14, A&E attendance rates are expected to continue to increase, making it essential that the government takes action to arrest this trend.

In the short term, the Department of Health allocated £650 million to relieving pressure on A&E services over the next two years, £400 million of which will be spent this winter. This will be used to add extra capacity and drive recruitment both within emergency departments and other parts of the health service.

Moreover, awareness campaigns will be run to ensure people with common and easily treatable conditions are able to get the advice and medication they need from other sources - including GPs and pharmacists - instead of coming to A&E.

Taking a longer-term view, the government is hoping to effect system-wide reform to improve care for people with chronic conditions, while expanding the availability of community-based healthcare services.

By giving GPs greater responsibility for individual patients, enhancing care quality for older people, facilitating the sharing of patient data and taking a more integrated and joined-up approach to medical treatment, the NHS should be able to help more patients avoid the need for emergency care entirely, thus ensuring A&E services are able to operate sustainably and effectively.

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