Patients Facing ‘Lottery’ Over Emergency Care

By Mike Waites

Needless delays, confusion over access to services and poor out- of-hours care were uncovered by the Healthcare Commission in a comprehensive review of NHS emergency and urgent care.Services in one in six areas including North Yorkshire, Calderdale and North Lincolnshire were rated “least well” performing.A third of areas ran “best performing” services including Bradford, Barnsley, Rotherham and Hull.The commission said a new drive was needed to improve co- ordination of services, which include ambulances, accident and emergency, out-of-hours GP services, NHS Direct, daytime urgent care by GPs and urgent care centres including minor injury and walk-in centres.The investigation found the proportion of calls to out-of- hours GPs rated as “urgent” ranged from a third to a worrying four per cent.Massive variations were found in 999 ambulance response times and services in parts of Yorkshire were among the slowest in the country.The commission noted improvements had been made in casualty units, 98 per cent of patients being seen within the four- hour target in 2007-8 compared with 91 per cent in 2003-4 despite a huge rise in people seeking treatment.It found performance was generally worse in fields that were not bound by Government targets and calls for a single number for urgent care services to help people access care.The commission chief executive, Anna Walker, said: “How an area deals with emergency and urgent care is absolutely a cornerstone of 21st century care.”But more could be done to get these services working together so that the right care is provided at the right time and in the right way.”People often don’t know which services to use and too often have to repeat their story time and again because services don’t always share information effectively.”Navigating between services can be difficult and confusing for patients and this can have a real impact, especially on people with more complex needs, such as older people and people with disabilities.”The Government’s emergency access czar, Prof Sir George Alberti, said urgent and emergency care for millions of people was of high standard.”We are not complacent and we recognise the importance of encouraging continuous improvement in local services to ensure the delivery of timely, high quality care to patients,” he said.But Tory Shadow Health Minister Mike Penning said: “This report shows that, yet again, the Government is often hitting self-imposed targets but missing the point in providing care.”Conservatives have proposed a far simpler pathway for urgent care, giving the public two clear options: 999 for an emergency or another single number for all non-emergency healthcare inquiries and responses.”Liberal Democrat health spokesman Norman Lamb said the report exposed “totally unacceptable” variations.”This is potentially a matter of life or death and poor performance can result in lives lost. Emergency care should be the cornerstone of an efficient NHS,” he said.The director of commissioning in Calderdale, Kevin Roberts, said “significant” service improvements had already been made.Ambulance response times had improved in real terms, GP surgeries were opening longer and there was better co-ordination between all health services. From April next year, urgent care services would see further improvements to make them more patient focused.Health chiefs in North Yorkshire and North Lincolnshire blamed difficulties accessing information which meant they were unable to give the commission a full picture of services.Gary Hardman, from North Yorkshire and York Primary Care Trust (PCT), said it would study the findings carefully.

(c) 2008 Yorkshire Post. Provided by ProQuest LLC. All rights Reserved.