University Hospital Coventry announced that this week that it had its highest ever number of attendees in one day. 600 patients in 24 hours. By comparison, Queen’s Hospital in Romford, one of the busiest A&E wards in the UK, regularly sees approximately 400 patients a day.
As has been widely reported recently, there are a number of factors contributing towards this rise. Community care has suffered under the funding cuts, and elderly and vulnerable patients are finding that there is less availability to be treated for minor to moderate health problems at home. GP surgeries are unable to provide appointments for several weeks, pushing people to seek care through A&E. A recent poll by Healthwatch England found that approximately 20% of patients admitted that they were using A&E for non-urgent minor health concerns because of problems accessing their GP.
The NHS has also seen widespread closures of other frontline services over recent years. The Telegraph reported last November that 1 in 4 NHS walk-in centres have closed since 2010. The purpose of these walk-in centres was to ease the strain on A&E and provide patients with minor to moderate, less urgent health concerns with a resource that they could access outside of their GP. When these are taken away, the patients simply have to go somewhere, and A&E is the most visible option.
The reality is that A&E shouldn’t necessarily be ‘the frontline’, but part of a frontline of services for patients suffering from a severe accident or healthcare emergency. It should be part of a network that should include GPs, walk-in centres, and community care. There really shouldn’t be any surprise that if you take away the access to these other options, anyone with any healthcare concerns will head straight to A&E. This causes the level of high volume attendance that is putting pressure on departments already at breaking point, and as I am seeing in my work as a medical negligence solicitor, causing mistakes to happen. It is leading doctors to feel, as reported by Dr Ahsan in The Guardian this week, that “being a doctor in accident and emergency has at times resembled being a medic in a war zone”. The concern is that as this crisis continues, more and more patients are going to be put at serious risk and have nowhere else to turn to.