The College of Emergency Medicine (CEM) yesterday warned that is it misguided to downgrade or close hospital Accident and Emergency departments.
The college stressed that ‘recent reports have confirmed that patients do not attend Emergency Departments (EDs) inappropriately.
‘Expensive new initiatives such as walk-in and urgent care centres aimed at moving patients away from EDs are therefore flawed.’
The CEM added that many plans are based on an assumption that is ‘simply untrue’ – namely that 60 per cent of people coming to A&E have relatively minor problems that could be sorted out elsewhere, for example in privately-run minor injuries units or polyclinics.
CEM president, Dr John Heyworth said: ‘It is a mantra which has driven strategy for a number of years, but our evidence from the College of Emergency Medicine and other evidence from recent research has confirmed that it’s nowhere near 60 per cent.’
Dr Heyworth added that this proves that most patients going in to A&E need the expertise and resources that can only be offered by a hospital emergency department.
He said: ‘We need to strengthen our emergency departments and if we want to consider different strategies they must only be on the basis of robust, reliable clinically-led evidence – and at the moment that’s not applying in many places.’
Stressing the importance of consultant-led A&Es, the CEM called for a substantial increase in the number of emergency medicine consultants.
It said in a statement: ‘The College of Emergency Medicine (CEM) is today calling on the next government to address extreme understaffing of Emergency Departments (EDs) and ensure a high quality, guaranteed 24/7 point of access for patients.
‘The College says every ED needs a minimum of ten Emergency Medicine Consultants to be able to deal with the large number of patients who visit the ED per year.
‘The current average number of EM Consultants per ED is 4.2 and the average number of patients attending each ED is between 70-80,000 per annum.
‘Increasing this number will mean more Consultants in EDs at the evenings and weekends, ensuring highest standards of quality and safety.
‘Significant cost benefits will also be achieved by helping to reduce expensive or inappropriate investigations, unnecessary admissions and unsafe discharges home.’
CEM president Dr Heyworth said: ‘Emergency care in the United Kingdom is currently failing to deliver the service which the public expect and deserve.
‘The single most important factor in providing a high quality, timely and clinically effective service to patients is care led by EM Consultants.
‘We are concerned that patient outcomes may suffer if this failure to invest in Emergency Medicine continues.’
Dr Andrew Hobart, British Medical Association Emergency Medicine Committee, agreed that assumptions behind the re-organisation of urgent and emergency care were ‘fundamentally flawed’.
