A&E 'winter crisis': Call to put GPs in hospital emergency departments

Report also calls for surgeons 'at the front door of the hospital'

A coalition of leading doctors’ organisations has warned that the NHS faces “walking blindfolded into another winter crisis” if it does not overhaul the relationship between emergency care, primary and social care.

To tackle the “overwhelming” number of patients seeking urgent care the NHS should make out-of-hours GP service available at hospital emergency departments, according to a major new policy recommendation from the Royal College of Emergency Medicine.

The report has also called for GPs to have direct lines to A&E consultants to seek their advice, for surgeons to be located “at the front door of the hospital” and for community care to be located in emergency rooms to “bridge the gap” between emergency and social care.

These are among 13 major policy recommendations in the Acute and Emergency Care: Prescribing the Remedy report, which has the backing of the Royal College of Paediatrics and Child Health, the Royal College of Physicians and the Royal College of Surgeons, as well as the College of Emergency Medicine

It  goes on to argue that patients should no longer have to face the default choice or whether they need emergency attention or more minor treatment at an out-of-hours centre, rather they should have access to both levels of care at the same location.

Senior doctors contributing to the report also recommended that community care and social care should be available seven days a week to support urgent and emergency care services, which would mean patients could be safely discharged outside of normal working hours.

The College of Emergency Medicine wants community care to be located in emergency rooms to 'bridge the gap' between emergency and social care The College of Emergency Medicine wants community care to be located in emergency rooms to 'bridge the gap' between emergency and social care (Getty) In a strongly-worded warning to Government the president of the College of Emergency Medicine, Dr Clifford Mann, said “It would be nothing short of a scandal if these recommendations were not acted on. The time for action is now.”

Sir Richard Thompson, president of The Royal College of Physicians, said “Over the past few years, services for ill patients have been stretched by the sheer amount of acute and emergency admissions, and we have to plan better for the future to protect patient safety. These thirteen recommendations are practical, evidence-based, and produced by doctors who care for patients daily – if we do not implement them, we shall simply walk blindfold into another winter crisis.”

These stark warnings come after the organisations called an “emergency summit” in response to the “profound pressures” facing patients and doctors in emergency wards across the country.  This follows new NHS figures last month showed that the country’s accident and emergency centres are busy than at any time since records began, and show no sign of dipping during traditionally quieter summer months.

The performance of A&E departments across the country is being closely watched by Government – along with key NHS waiting list targets and GP referrals. The Government is reportedly concerned that poor performance this summer may foreshadow and bad winter, with the Conservative leadership desperate to avoid bad NHS headlines in the run up the General Election.

In response up to £350m has been set aside for emergency and preventative hospital treatment, across the country, along with another £50m for improvements to the NHS 111 non-emergency phone line and ambulance services.

A spokesperson for the Department of Health said, “We will look closely at this report from the College of Emergency Medicine, and indeed, are pleased to have their endorsement for recent guidance given to the system on year-round operational resilience. We will continue to collaborate with the College as we seek to deliver the best quality care for patients.”

The 13 recommendations

1) Out-of-hours GPS at every A&E department

2) Sharing best practise to give patients “right care, first time”

3) All trainee specialty doctors to spend time in A&E departments

4) Surgeons at “front door of the hospital” to make key decisions

5) Focus on correct “skills mix” at emergency departments

6) Deploy extra staff at “times of peak activity”

7) Social care available at A&E departments seven days a week

8) Community teams based at every A&E departments to support “vulnerable patients”

9)  Consultants and diagnostics support available all day, every day to herald “seven-day service in the NHS”.

10) New funding and target rules

11) New contracts for staff work-life balance

12) Effective IT infrastructure

13) Doctors involved with NHS 111 and NHS Direct

Arts and Entertainment
Game Of Thrones
Uh-oh, winter is coming. Ouch, my eyes! Ygritte’s a goner. Lysa’s a goner. Tywin’s a goner. Look, a dragon
tvSpoiler warning: The British actor says viewers have 'not seen the last' of his character
Arts and Entertainment
'New Tricks' star Dennis Waterman is departing from the show after he completes filming on two more episodes
tvOnly remaining original cast-member to leave long-running series
The Etihad Stadium, home of Manchester City
premier leaguePlus all the build-up to Man City vs Chelsea and Everton vs Palace
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Life and Style
ebooksFrom the lifespan of a slug to the distance to the Sun: answers to 500 questions from readers
Polly Borgen at the Tribeca Film Festival in 2012
peopleThe Emmy award-winner starred in Cape Fear, the Sopranos and Desperate House Wives
people'I hated him during those times'
Britain's shadow chancellor Ed Balls (L) challenges reporter Rob Merrick for the ball during the Labour Party versus the media soccer match,
peopleReporter left bleeding after tackle from shadow Chancellor in annual political football match
Rumer was diagnosed with bipolarity, attention deficit hyperactivity disorder and post-traumatic stress disorder: 'I was convinced it was a misdiagnosis'
peopleHer debut album caused her post-traumatic stress - how will she cope as she releases her third record?
Arts and Entertainment
Lauryn Hill performing at the O2 Brixton Academy last night
musicSinger was more than 90 minutes late
Arts and Entertainment
tvReview: 'Time Heist' sees a darker side to Peter Capaldi's Doctor
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Head of Marketing and Communications - London - up to £80,000

    £70000 - £80000 per annum: Ashdown Group: Group Head of Marketing and Communic...

    Nursery Nurse

    Negotiable: Randstad Education Manchester: Level 3 Nursery Nurse required for ...

    Nursery Nurse

    Negotiable: Randstad Education Manchester: L3 Nursery Nurses urgently required...

    SEN Teaching Assistant

    Negotiable: Randstad Education Manchester: We have a number of schools based S...

    Day In a Page

    Scottish referendum: The Yes vote was the love that dared speak its name, but it was not to be

    Despite the result, this is the end of the status quo

    Boyd Tonkin on the fall-out from the Scottish referendum
    Manolo Blahnik: The high priest of heels talks flats, Englishness, and why he loves Mary Beard

    Manolo Blahnik: Flats, Englishness, and Mary Beard

    The shoe designer who has been dubbed 'the patron saint of the stiletto'
    The Beatles biographer reveals exclusive original manuscripts of some of the best pop songs ever written

    Scrambled eggs and LSD

    Behind The Beatles' lyrics - thanks to Hunter Davis's original manuscript copies
    'Normcore' fashion: Blending in is the new standing out in latest catwalk non-trend

    'Normcore': Blending in is the new standing out

    Just when fashion was in grave danger of running out of trends, it only went and invented the non-trend. Rebecca Gonsalves investigates
    Dance’s new leading ladies fight back: How female vocalists are now writing their own hits

    New leading ladies of dance fight back

    How female vocalists are now writing their own hits
    Mystery of the Ground Zero wedding photo

    A shot in the dark

    Mystery of the wedding photo from Ground Zero
    His life, the universe and everything

    His life, the universe and everything

    New biography sheds light on comic genius of Douglas Adams
    Save us from small screen superheroes

    Save us from small screen superheroes

    Shows like Agents of S.H.I.E.L.D are little more than marketing tools
    Reach for the skies

    Reach for the skies

    From pools to football pitches, rooftop living is looking up
    These are the 12 best hotel spas in the UK

    12 best hotel spas in the UK

    Some hotels go all out on facilities; others stand out for the sheer quality of treatments
    These Iranian-controlled Shia militias used to specialise in killing American soldiers. Now they are fighting Isis, backed up by US airstrikes

    Widespread fear of Isis is producing strange bedfellows

    Iranian-controlled Shia militias that used to kill American soldiers are now fighting Isis, helped by US airstrikes
    Topshop goes part Athena poster, part last spring Prada

    Topshop goes part Athena poster, part last spring Prada

    Shoppers don't come to Topshop for the unique
    How to make a Lego masterpiece

    How to make a Lego masterpiece

    Toy breaks out of the nursery and heads for the gallery
    Meet the ‘Endies’ – city dwellers who are too poor to have fun

    Meet the ‘Endies’ – city dwellers who are too poor to have fun

    Urbanites are cursed with an acronym pointing to Employed but No Disposable Income or Savings
    Paisley’s decision to make peace with IRA enemies might remind the Arabs of Sadat

    Ian Paisley’s decision to make peace with his IRA enemies

    His Save Ulster from Sodomy campaign would surely have been supported by many a Sunni imam