Two views seem to be developing. One is that it is better to adapt provision to demand, the other that A&E units should aggressively deter non-emergency cases. The first approach takes a patient-centric view - that care should be structured around patient needs. So if people want to get care through a walk-in service then that should be used as a starting point. Patients then can be sorted through a triage process and seen, either in the emergency department if appropriate or by an attached GP centre if not. The second approach says that a high percentage of patients have no business in A&E. They should just be deterred. There are arguments for and against; obviously the first model requires resourcing. The second model is effectively the standard approach, but it is hoped that by ramping up deterrence this will restrict inappropriate use. The trouble with this is that certain users of A&E are plainly incorrigible and will turn up regardless, whereas other legitimate users plainly are deterred. Therefore it seems that, like it or not, the first approach is the way forward.
Posted on: Tue, 02 Jul 2013 09:13:21 +0000
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