Out-of-hours doctor service puts strain on A&E units
The number of people attending A&E has gone up by 1.35 million over the last 5 years according to a report by the Nuffield Trust, an independent health charity. As more GPs opt out of working nights and weekends as part of a controversial new contract, more and more A&E units are feeling the strain.
Since local GPs have been able to opt out, A&E admissions have increased by 12%. With increased demand on A&E units, figures suggest that this is costing the NHS an extra £330 million as the need to meet the demand places considerable strain on resources and hospital staff. Many A&E units are seeing increasing number of patients with medical conditions that would have normally been covered by their local GP’s out-of-hours service turning up over the weekends or in the evenings. To meet the rising demand more primary care trusts are hiring locum doctors, many of them from overseas and with a poor grasp of English.
The report also found emergency admissions now make up 355 of all hospital attendances, costing the NHS £11bn per year. But the proportion being admitted to A&E who are discharged 24 hours later has also increased from 42% in 2004/5 to 49% in 2008/9. Dr Jennifer Dixon, director of the Nuffield Trust said, “Patients regard A&E as the easiest, less risky option. Clearly the care provided outside hospital is lacking and that is going to fuel an increase in the number of people going to casualty.” John Heyworth, president of the College of Emergency Medicine, which represents A&E doctors said, “The simple fact is that care outside of hospital is fragmented, inconsistent and confusing. Many patients just don’t know where to go for their out-of-hours services – the whole system changes out-side the hours 8am to 5pm, Monday to Friday. Some services have doctors, some don’t. Patients just don’t know what to expect. They often have to wait a long time before they are seen. But they know if they go to an emergency department they will receive a very high quality of care. It is the only service that can be relied upon 24/7. ” Mr Heyworth added, “that just because there had been a rise in patients attending A&E, it did not mean that they did not have potentially serious conditions. Many come in with chest pain or headaches which could be serious and all need checking out.”
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