Doctors offer 9-point plan to save NHS from collapse

For many NHS workers, including striking workers, the extra money is the only way to avoid the crises that hospitals are currently facing.

Trusts are reporting critical incidents as they grapple with rising Covid and flu cases. Patients have to wait hours for help as staff burn out more and more. These states can last for months.

But emergency room experts say there are several short-term ways to reduce demand for services that go beyond spending money.

More emergency services for 111 calls

More than half of NHS 111 employees are doctors. Suzanne Mason, professor of emergency medicine at the University of Sheffield, said having even more doctors on call could reduce the number of patients needlessly ending up in the emergency room by treating health problems more effectively from the start.

she said I: “They go through the system very inefficiently and often end up in an ambulance or emergency room, which is the crucible of all the problems that no one knows how to deal with.

“I think if we could put some of our clinical experience into the system more efficiently, we could cut some of that demand down a lot.”

Reduce bed clogging

There are up to 200 patients in some hospitals who can travel but cannot be discharged due to a lack of social assistance, doctors say. This means that fewer beds are available for people who need them.

Professor Mason said some hospitals need to better assess the risk of discharge for certain patients.

“When I talked to people working in teams in the neighborhood, they often said: “We know that Mrs. So-and-so is in danger of falling, and this will not change.” So why don’t we just take her home and deal with this the best we can?

“It’s probably better to do that than keep her in the hospital where she’ll only get worse and possibly never come home.”

Professor Mason said that the hotels were hardly suitable for receiving patients, as some suggested. But she supported the return of cottage hospitals, which once served as a springboard for patients after treatment and before returning home.

Give pharmacists more responsibility

Another way to ease the burden on hospitals is to give pharmacists more responsibility for treating patients, Prof Mason said, even though their sector also faces its own staffing and retention issues.

keep patients healthy

It may seem obvious, but making sure people don’t get sick takes the pressure off emergency services. This includes getting vaccinated and getting advice from a doctor about illnesses in a timely manner.

Professor Mason said that some young people don’t see their GP early enough, perhaps because they don’t have time for appointments.

escalation departments

“Escalation stations” and extra beds are desperately needed to ease the pressure, said an emergency services worker based in Surrey. I. She asked to remain anonymous.

My last night shift [before the new year] It was possibly the worst service – I’ve been a doctor for 10 years – in my life.

“There were no beds in the hospital. The wards have already received more patients than they can accommodate.

“US [resuscitation area]where the sickest patients go when the blue light ambulance is full.

“We had 22 [patients] in the hallway with no hope of extra beds, no way to get ambulances out because all the other hospitals in the area were in the same location. It’s hard to do something more efficiently when your options are exhausted.

“Ideally, we needed some emergency departments to open that night so we could get some of the patients who came in from the emergency department to the departments, but they didn’t have extra nursing staff.”

The operative said: “Now we need more beds in the hospital, because the social plan will work. So we need to open more beds, which means we need more money to pay staff to maintain those beds.”

But to mitigate the systemic problems that led to the NHS winter crisis, wages need to rise to recruit and retain staff.

cancel operations

Dr. Nick Scriven, an emergency medicine advisor and former president of the Society for Emergency Medicine, said the only practical action hospitals can take at this time is to suspend scheduled treatments for a week or two. [the] The whole system can work together to remedy the situation.”

However, the A&E registrar stated that the cancellation of selective transactions may cause more problems in the future.

“You cancel an election and then see the complications of canceling an election later turn into an emergency. This gives you a few extra beds, but in the long run you create more problems for the future. If you don’t get a stent for heart disease now, you’ll have a heart attack in six months instead.

Best Communication

Improving direct communication between secondary and primary care staff will ensure that patients are treated with the most appropriate services and minimize avoidable referrals, said leaders of the Society for Emergency Medicine, the Royal College of Physicians of London, the Royal College of General Practitioners, the Royal College of Psychiatrists and Royal College of Emergency Medicine.

Out-of-hours care

In their updated plan to transform NHS emergency and emergency care, leaders said emergency rooms “shouldn’t be the norm” and that local health systems should develop “a seven-day set of options that NHS 111 and primary care broadcast to patients.”

They support the use of pharmacies, light trauma stations, and after-hours GP appointments.

Referrals to specialized hospitals

Patients requiring care in specialized hospital wards should be provided with an “immediate response and treatment plan” to help avoid hospital delays, leaders said. A pre-planned plan allows you to quickly get them out of the ambulance and safely treat them in the right room.

Dr. Tim Cooksley, President of the Society for Emergency Medicine, said earlier: “This is a time of crisis and there are fears that things will only get worse in the coming months. As such, leaders must prioritize the improvements we can make now that will help us get through this turbulent time.”