Management and monitoring of the pre-hospital care environment

Topics: National Health Service, Better, Hospital Pages: 4 (1149 words) Published: February 18, 2014
Reforming & Improving Emergency Care

In October 2001, the Department of Health (DoH) document ‘Reforming Emergency Care’ took on the challenges of the emergency care system within Britain, stating that “too many people have to wait too long for the care and treatment they need” (DoH, 2001b, p. 1). The document outlined the key areas it felt represented the need for reform. Each stage of the emergency care system went under review, from access to GP services and ambulance response times, to the experience of the patient upon arrival in hospital through to the provision of treatment and care packages allowing them to be discharged home again.

The reports objectives were to cut ambulance response times to life-threatening emergencies, end widespread bed-blocking in the NHS, improve access to GP and other primary care professionals, minimise cancellations of on-day surgery and cut accident and emergency (A&E) waiting times to under 4 hours. This would, in the reports opinion, “bring the response to everyday events up to this first class standard” (DoH, 2001b, p. 1).

A number of challenges faced this reform and were highlighted by the report. Workforce issues, for example staff capacity in A&E departments, were overstretched due to the significant increase in the demand for emergency services. To combat this, the increase in funding for the recruitment of A&E Nurses and consultants outlined in ‘The NHS Plan, A plan for investment, a plan for reform’, (DoH, 2000, p. 77), meant that at busier periods, senior presence would still be available and the demand met without causing delays to patients.

The resources used by emergency care services are often fully stretched. The report highlighted how capacity in hospitals is not sufficient and this, along with delays in discharging patients from hospital impacts these resources leading to high risk of long waits for admission and cancellation of planned operations. Too often, patients are medically ready to leave...

References: Great Britain. Department of Health. (2000). The NHS Plan: A Plan for Investment A Plan for Reform. London: HMSO.
Great Britain. Department of Health. (2001a). National Service Framework for Older People. London: HMSO.
Great Britain. Department of Health. (2001b). Reforming Emergency Care. London: HMSO.
Great Britain. National Audit Office. (2004). Improving Emergency Care in England. London: HMSO.
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