Shake Up For Welsh Emergency Care Service

PLANS to ease pressure on over-stretched A&E departments and simplify patient access to emergency care in Wales will be unveiled today.

The Delivering Emergency Care Services (Decs) strategy is expected to contain proposals for a network of urgent care centres built within hospitals across the country, which will divert patients away from A&E.

These centres will see patients who do not fit the strict emergency or trauma criteria, which A&E is designed to treat, but who have a condition which needs urgent treatment.

The strategy is also expected to contain details of how to make access to all kinds of emergency care – from GP out of hours services to A&E – easier for patients to access. This could include better triage services to ensure patients are directed to the most appropriate service. And, in the future, patients are more likely to be seen by a senior clinician – a doctor or nurse – rather than a more junior health professional, in a bid to make emergency care more efficient and effective.

The blueprint aims to ensure patients are seen by the right person in the right setting at the right time, rather than spending hours sitting in a crowded A&E department with a health complaint which could have been better dealt with by another branch of the NHS.

Health Minister Edwina Hart will officially unveil the proposals, which have been almost three years in the making, later today.

It is understood she will also announce that new telehealth technology will be installed in rural and remote minor injury units, to link them to major A&E departments, providing patients with better care close to their homes.

Tina Donnelly, director of the Royal College of Nursing in Wales, said, “Patients are totally confused at the moment about where to turn up so they go to the place of least resistance – that’s A&E and that’s not appropriate.

“It also means that patients who do need A&E services are not getting the care they need. The status quo is not an option – some change has to take place.”

And Dr Tony Calland, chair of the British Medical Association’s Welsh Council, said, “More experienced clinicians seeing patients when they come through the door means that difficult, hidden conditions will be picked up more quickly. And those without serious conditions will be able to be discharged sooner, without having to be put through unnecessary investigations that might have been instigated by someone with less experience.”

The plans to overhaul emergency care come as the number of people attending A&E or calling for an ambulance keeps increasing. It is estimated up to 35% of the patients who go to A&E could be better treated elsewhere.

The Decs strategy will start to be implemented this year, although some changes – including building urgent care centres – make take a couple of years.

Joe Conaghan, of Unison, which represents NHS and ambulance service staff, said, “Everyone needs to know that 999 will still be there – people will still be able to call for an ambulance.

“But in the future it may that a paramedic will do an element of triage and the next stop will not necessarily be A&E. In some cases, such as patients with a stroke or a heart attack, it may be straight into the stroke or cardiac unit, avoiding A&E altogether.

“Any work which makes people realise there is somewhere else more suitable for them to be treated has to be a great benefit to patients.”