Patient Wait Times and the Debate Surrounding A&E Closures

The NHS has long been under scrutiny about the level of care its hospital trusts provide to patients. New data has prompted countless concerns regarding wait times for those seeking urgent medical attention more frequently in recent months. A new report details that wait time targets in accident and emergency units (A&E) around the country have been missed fairly steadily over the last two years. Instead of seeing, diagnosing, treating, and releasing patients within the target four hours deemed sufficient by the health care powers that be for 95% of NHS visitors, hospitals throughout the system have failed by a 5% swing. The July numbers for A&E patient wait times are at a concerning 90.3% on average, with some A&E units missing the target wait time for nearly 16% of urgent patients.

Several well-known names in the healthcare arena have spoken out to defend the latest wait time numbers, starting with certainty that the targets have improved year over year. The glaring reality is that the NHS is finding it difficult to provide adequate treatment for patients in need of emergency medical care in a timely fashion, partly because of a steady increase in the number of patients visiting A&E units each month. In April, it was reported that the number of individuals seeking care through A&E units throughout the country had risen 3.3% over the previous month, and a 2.9% increase year over year. With greater pressure placed on A&E units due to the greater number of patient visits, wait time targets are not likely to be met until a shift takes place in the country’s healthcare system at large.

A Shift in the Wrong Direction?

Earlier this year, an announcement to close or downgrade A&E units was released, creating more concern over the future of patient care. As part of a five-year initiative to decrease annual spending throughout the health care system by way of multiple sustainability and transformation plans, regions where an A&E unit currently operates are facing a reorganisation to focus more on primary care services. The shift away from A&E units is intended to reduce the population’s reliance on emergency departments for health care issues that may be less severe. A move toward a consolidation of services staffed by GPs instead of emergency care providers, combined with the use of up-to-date technology in the delivery of services in patients’ home is meant to relieve some of the pressures placed on hospitals struggling to meet patient wait times. Currently, wait time targets include all facets of care, from serious medical conditions that require immediate diagnosis and treatment to minor injuries and illnesses that may be better served in a primary care setting.

Transitioning patients to a model more heavily focused on preventative and primary care through the closure and downgrade of A&E units may not have the intended effect. Although the system may experience a reduction in overall costs, patients may suffer the consequences through lackluster care or increased wait times, not to mention confusion as to which NHS outlet they are to visit to receive medical attention.

What’s Next for Patient Care

The reports surrounding NHS wait times are not the only cause for concern in the healthcare environment. An increase in the number of patients visiting both emergency and primary care facilities throughout the UK has some distressed about the future of healthcare as a whole. As the population continues to age and simultaneously grow, doctor’s offices, A&E units, and specialist departments are being stretched to the limit. A solicitor from a medical negligence firm that works with several A&E claims explains that the combination of these factors poses a threat to the viability of the system which in turn may negatively impact the quality of care received by patients. Bed-occupancy rates are at all-time highs, which means the transition from diagnosis to treatment to release is far from timely. Add to this the closure and downgrade of already stressed emergency departments and patients may be unable to heal and recover from illness or injury in the best possible manner.

The NHS is up against a variety of negative pressures, not the least of which is the need to reduce costs to create a sustainable healthcare organisation. However, the closure and downgrade of some emergency departments may only prove beneficial on the balance sheet, not for patients or their providers. There is no easy fix for problems within NHS, given the factors at play are complex and far-reaching, but most feel strongly that swapping the quality of patient care for a reduction in overhead expenses isn’t a long-term solution.