Waiting times in A&E departments

Waiting times in accident and emergency (A&E) departments are a key measure of how the NHS is performing. In recent years, patients have been waiting longer in A&E; this article from the Kings Fund explores the reasons behind this.

The article reports that not only are more people are attending A&E departments each year, but A&E waiting times have also increased substantially over recent years. The NHS has not met the standard at national level in any year since 2013/14, and the standard has been missed in every month since July 2015.

At the same time, longstanding staffing issues and continued reductions in the number of hospital beds have made it more difficult for A&E departments to admit patients.

Full article: What’s going on with A&E waiting times?

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Addressing ambulance handover delays

NHS England has written to ambulance trusts setting out actions that need to be embedded as part of normal working practice, and actions to be taken should ambulances begin to queue.

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 ‘Addressing ambulance handover delays: Actions for Local A&E Delivery Boards’ sets out the main points from recent guidance documents, and separates them into actions to be embedded as part of normal working practice, and actions to be taken should ambulances begin to queue.

There are 4 key principles:

  • The patients in the urgent care pathway who are at highest risk of preventable harm are those for whom a high priority 999 emergency call has been received, but no ambulance resource is available for dispatch.
  • Acute Trusts must always accept handover of patients within 15 minutes of an ambulance arriving at the ED or other urgent admission facility (e.g. medical/surgical assessment units, ambulatory care etc.)
  • Leaving patients waiting in ambulances or in a corridor supervised by ambulance personnel is inappropriate.
  • The patient is the responsibility of the ED from the moment that the ambulance arrives outside the ED department, regardless of the exact location of the patient.

Full document:  ‘Addressing ambulance handover delays: Actions for Local A&E Delivery Boards’

A&E waiting times: £360m needed to meet targets

Winter is coming. How much would it cost to keep the pressure down? | The Health Foundation | Story via OnMedica

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New analysis from the Health Foundation suggests that this winter could see the worst performance against the NHS four-hour A&E target since records began in 2004-5.

The analysis uses projected trends in A&E attendances, the number of people waiting over four hours at A&E, and the number of those needing admission but waiting over four hours for a bed. The projections suggest that around 735,000 people will wait longer than four hours in the last quarter of 2017-18 (January – March), equal to a 311% increase on winter 2010-11.

The NHS aims to admit, discharge, or transfer 95% of people within four hours of arriving at A&E. But in a worsening financial climate, hospitals are now struggling to meet this target all year round, not just in winter.

Full analysis: The Health Foundation:  Winter is coming. How much would it cost to keep the pressure down?

See also: OnMedica:  Millions needed to shore up NHS this winter, says think tank

 

Winter pressure in A&E: response to Health Select Committee

The government’s response to the House of Commons Health Select Committee report on winter pressure in accident and emergency departments.

This report responds to each of the 27 conclusions and recommendations in the Health Select Committee’s report, Winter Pressure in A&E Departments . It highlights how the NHS prepares for winter, as part of its year-round operational resilience planning, to ensure the health and social care system in England is fully prepared for the increased pressures at that time of year.

Full document: Government Response to Health Select Committee Report on Winter Pressure in Accident and Emergency Departments

NHS needs more advanced paramedics to ease A&E pressure

Paramedics with advanced training can reduce the number of patients admitted to hospital unnecessarily, says NICE.

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Image source: Carl Spencer – Flickr // CC BY-NC 2.0

NICE is recommending the NHS provides more advanced paramedic practitioners (APPs) to relieve pressure on emergency departments, in new draft guidance. Evidence reviewed by NICE shows that using APPs can reduce hospital admissions by 13% compared with standard paramedics.

The draft guidance also makes wider recommendations about emergency and acute medical services to standardise care across the NHS. It supports NHS England’s Five Year Forward View for the future of emergency medical services.

Full story available here

Half of A&Es to have specialist mental health teams by 2019

NHS England reveals plans to implement 24-hour specialist mental health teams in almost half of A&Es across the country by March 2019 | National Health Executive

News to implement 24-hour specialist mental health teams in almost half of A&Es across the country by March 2019 was announced in NHS England’s update to the Five Year Forward View, which outlined a number of new aims and initiatives to tackle chronic problems within mental health care nationally.

 

NHS England will look to improve the number of ‘talking’ therapies offered by the NHS, as 60,000 more people will receive these services by the end of 2017-18, rising to 200,000 more people getting care by the end of 2018-19.

New frameworks to facilitate faster access to digital therapies are also to be developed by NHS England alongside NICE.

Read more at National Health Executive

A&E under pressure

The number of patients waiting four or more hours at A&E has risen more than 300% at some hospitals |  BBC News

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In total, 2.2 million patients were not seen within the target time in 2015-16 – more than double the one million figure in 2013-2014.

The Royal College for Emergency Medicine (RCEM) says there is a “large and systemic problem” caused by a lack of hospital beds.

NHS England said hospitals were under pressure but continuing to cope. Across England in 2015-2016, 85% of patients were seen within four hours.

Full story via BBC News