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A&Es seek to divert patients due to pressure but should focus be on effective treatment?

Relieving pressure on A&Es is becoming more important than ever with hospitals struggling to cope with unprecedented demand meaning the most seriously ill face delayed treatment and the danger this poses.

But at the same time out-of-hours GP services remain so poor in some areas that when illness strikes patients are left with no alternative but to go to A&E when in need of urgent, but perhaps not life-threatening, care.

This winter, to ease pressure on A&E services, hospitals have been told to establish a GP and nurse screening system at the point of entry so that some patients can be diverted to urgent care centres or for follow up with their own surgeries (Telegraph).

In principal this sounds sensible. However, when you factor in the difficulties many patients have in accessing GP appointments and a further journey to an urgent care centre in the dead of the night it’s clear this is just shifting the problem elsewhere.

It is also a concern that patients with serious illnesses could slip through the net. The specialist medical negligence solicitors at JMW have seen the devastation misdiagnosis of life-threatening conditions such as sepsis and meningitis can have. They can cause death and disabilities and we are currently helping several families whose loved one has not received timely treatment to challenge the mistakes that were made. Their symptoms can be vague and similar to more common and harmless infections but there are subtle differences. Minutes count with these conditions and any delay can have serious consequences.

Are staff in a busy triage system, which has the main aim of reducing the number of patients, going to spend the time needed when on face value the patient could be suffering from a harmless virus? Will this push on diverting patients raise the potential for these sorts of cases to be overlooked? Hopefully not but even one such case is one too many and with young children being the ones at greatest risk due to their immature immune systems there is much at stake.

Would it not be better to focus these screening services on sites that are dedicated to treating patients effectively and then sending to A&E if warranted? To reduce pressure on A&E units there must be a suitable alternative. No one wants to sit waiting for hours in a busy hospital if they don’t need to but for many it is the only place they know they will get to see a medical professional that day. The patient cannot be lost in all this and it is their health and care that is at stake.

This latest step by the NHS seems like a knee-jerk reaction that runs the risk of creating more chaos. However, foresight, planning and investment in steps that will ensure safety and longevity of services in a cost-effective manner have never been strong points of those at the helm of the health service. It looks like the firefighting is set to continue this winter but I hope that patients do not pay the price of that.





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