Most patients need A&E

Topics covered: Ridouts professional advice

Doctors have said that efforts to redirect patients away from busy A&E departments will not work.

According to The College of Emergency Medicine review of more than 3,000 patients, only 15% of patients could have been treated in the community. Last year NHS England suggested 25% of patients could be treated in the community and this was used to justify a major shake-up of A&E units.

The College of Emergency Medicine said it is not opposed to NHS England’s proposed creation of a two-tier system involving major and minor A&E units but it said the expectation that large numbers of visits to A&E could be prevented was likely to be wrong and that it was important to take other steps to relieve pressures.

One of the steps suggested is to have GPs located in or alongside A&E units to filter out the less urgent cases, a measure which is already happening in a number of hospitals.

The review into emergency medicine considered what was happening in 12 A&E units over a 24-hour period in March. It found 85% of patients needed to be seen in A&E but that 22% could have been dealt with by a GP on site if there had been one.

Katherine Murphy of the Patients Association, said: “For many years patients have been wrongly criticised for abusing A&E departments and wasting NHS resources, but these latest figures show that the majority of these patients are genuinely ill and require urgent medical treatment. We cannot ignore these figures. There is an urgent need to look at the provision of NHS care in a joined-up way and ensure that the patient comes first in every decision made.”

However, a spokeswoman for NHS England said: “There have been several attempts to quantify the percentage of A&E attendances that could be readily managed elsewhere, with estimates ranging between 10 and 45%. Variation in these figures is due to the A&E departments studied, the types of patients attending, locally available services and the subjective judgement of those involved in giving the clinical opinion. This new figure from the College of Emergency Medicine therefore falls within the expected range.”

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