Commenting on the publication of NHS England’s review of urgent and emergency care, Nigel Edwards, Senior Fellow at The King’s Fund, said:
‘Today’s report provides a welcome dose of clarity in a debate that has become increasingly disjointed, and it outlines a coherent strategy for addressing the pressures facing the urgent and emergency care system. It is right to propose fundamental changes – tinkering at the edges will not deal with the scale of the problem, which reflects wider pressures on the NHS and social care system, not just on A&E.
‘If the strategy outlined in the report is to succeed, wider changes will be needed to improve care outside hospital. 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 coordination between hospitals, social care and community services.
‘While the solutions proposed by the report are the right ones, some of them will be a hard to sell to politicians and the public. The proposal to introduce two levels of hospital-based emergency centre and to concentrate specialist services in larger units is sensible but will be difficult to implement given people’s attachment to the A&E brand and resistance to changing local services. Significant work will also be needed to improve the NHS 111 service and to restore public confidence in it given recent negative publicity.’