There has been justified concern over A&E at Central Middlesex, but I have found it frustrating that the debate seems to have been carried on in isolation. That is not very useful if we actually want to help get people timely medical treatment rather than just a load of publicity. The Bruce Keogh proposals offer a chance to move to a more rounded debate.
Anecdotally, and with some statistical evidence, much of the potential overload seems to come from the difficulties in other parts of the NHS. People find it very hard to get a GP appointment, and the number of walk in centres is reducing. Therefore, increasingly people treat AE as a first resort. There may also be something in cultural change and GPs not working convenient opening hours.
There is also the worrying issue of cuts to the ambulance service at least in London. As I understand it stabilizing someone quickly is usually more important to their health than the time it takes to get to a hospital once they are in the ambulance.
Finally, there is the argument about the actual quality of the A&E once the patient actually gets there. Everyone I know with clinical expertise seems to think that the range of specialisms available is hugely important, and that a certain throughput of patients is crucial to that.
Sadly, none of these points have really featured in the public debate.
1 comment:
"As I understand it stabilizing someone quickly is usually more important to their health than the time it takes to get to a hospital once they are in the ambulance."
Absolutely!
So funding is critical to the better model of far fewer full-A&E departments.
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