It’s a good report but we need a firm strategy for A&E too

They will need to do a lot of work to give patients the confidence to ring 111

Share

This is a very sensible report and it has the potential to deal with many of the issues in A&E, but it is worth remembering that quite a lot of the problems are actually symptoms of wider issues – how care is provided to frail, older people with complex medical conditions, and how to discharge these people from hospital in a more timely manner. It’s about the back door of the hospital as well as the front door.

The logic for two different levels of A&E is pretty unassailable. There are indeed a number of places that call themselves A&E departments, which aren’t really A&Es in the way most people understand them.

There is an argument for changing the name so as to be much clearer about what these wards provide. Make the system simpler, make it easier to navigate, make sure people can understand it. But the “A&E brand” is strong, and changes could be politically contentious.

The idea of enhancing phone services is a good one. If you can direct more people to phone their GP, the ambulance service or 111, then you can direct patients to the right place at an early stage.

It is unfortunate that 111 had a rocky start. There are quite a few examples around the world, including in Denmark, where people have managed to shift more patients with minor conditions on to phone services. But they will need to do a lot of work to give patients confidence that they will get a definitive answer from 111, given recent negative publicity.

But what’s really needed is a strategy alongside this. This includes reforms to primary care to ensure it better meets the needs of people with long-term conditions by providing a wider range of services, closer to people’s homes. More timely discharge is also essential to free up beds for patients who need to be admitted to hospital from A&E – this requires much stronger co-ordination between hospitals, social care and community services.

Nigel Edwards is a senior fellow at health think-tank The King’s Fund

React Now

More From
Nigel Edwards
iJobs Job Widget
iJobs General

Legal Cashier - Oxford

Very Competitive: Austen Lloyd: Legal Cashier - Oxford We have an excellent ...

Legal Cashier - Oxford

Very Competitive: Austen Lloyd: Legal Cashier - Oxford We have an excellent ...

Production and Merchandising Assistant

£19,000 - £21,000: Sauce Recruitment: A contemporary, original wholesale distr...

PPC Account Managers

£25k - £30k (DOE): Guru Careers: Two expert PPC Account Managers are needed to...

Day In a Page

Read Next
 

The daily catch-up: Joe on Vlad, banks of the Jordan and Blair's radicalism

John Rentoul
 

Believe me, I said, there’s nothing rural about this urban borough’s attempt at a country fair

John Walsh
Some are reformed drug addicts. Some are single mums. All are on benefits. But now these so-called 'scroungers’ are fighting back

The 'scroungers’ fight back

The welfare claimants battling to alter stereotypes
Amazing video shows Nasa 'flame extinguishment experiment' in action

Fireballs in space

Amazing video shows Nasa's 'flame extinguishment experiment' in action
A Bible for billionaires

A Bible for billionaires

Find out why America's richest men are reading John Brookes
Paranoid parenting is on the rise - and our children are suffering because of it

Paranoid parenting is on the rise

And our children are suffering because of it
For sale: Island where the Magna Carta was sealed

Magna Carta Island goes on sale

Yours for a cool £4m
Phone hacking scandal special report: The slide into crime at the 'News of the World'

The hacker's tale: the slide into crime at the 'News of the World'

Glenn Mulcaire was jailed for six months for intercepting phone messages. James Hanning tells his story in a new book. This is an extract
We flinch, but there are degrees of paedophilia

We flinch, but there are degrees of paedophilia

Child abusers are not all the same, yet the idea of treating them differently in relation to the severity of their crimes has somehow become controversial
The truth about conspiracy theories is that some require considering

The truth about conspiracy theories is that some require considering

For instance, did Isis kill the Israeli teenagers to trigger a war, asks Patrick Cockburn
Alistair Carmichael: 'The UK as a whole is greater than the sum of its parts'

Alistair Carmichael: 'The UK as a whole is greater than the sum of its parts'

Meet the man who doesn't want to go down in history as the country's last Scottish Secretary
Legoland Windsor's master model-makers reveal the tricks of their trade (including how to stop the kids wrecking your Eiffel Tower)

Meet the people who play with Lego for a living

They are the master builders: Lego's crack team of model-makers, who have just glued down the last of 650,000 bricks as they recreate Paris in Windsor. Susie Mesure goes behind the scenes
The 20 best days out for the summer holidays: From Spitfires to summer ferry sailings

20 best days out for the summer holidays

From summer ferry sailings in Tyne and Wear and adventure days at Bear Grylls Survival Academy to Spitfires at the Imperial War Museum Duxford and bog-snorkelling at the World Alternative Games...
Open-air theatres: If all the world is a stage, then everyone gets in on the act

All the wood’s a stage

Open-air productions are the cue for better box-office receipts, new audiences, more interesting artistic challenges – and a picnic
Rand Paul is a Republican with an eye on the world

Rupert Cornwell: A Republican with an eye on the world

Rand Paul is laying out his presidential stall by taking on his party's disastrous record on foreign policy
Self-preservation society: Pickles are moving from the side of your plate to become the star dish

Self-preservation society

Pickles are moving from the side of your plate to become the star dish
Generation gap opens a career sinkhole

Britons live ever longer, but still society persists in glorifying youth

We are living longer but considered 'past it' younger, the reshuffle suggests. There may be trouble ahead, says DJ Taylor