Medics call for new healthcare hubs to ease 'crisis' in A&E


A&Es should become hubs where patients have access to GPs, pharmacists and geriatricians, leading emergency medics have said.

Such a move would help ease the "crisis" currently facing emergency departments, the Royal College of Emergency Medicine (RCEM) and the Royal College of Nursing (RCN) said.

The emergency department should become just one component of these hubs, according to the report: The Medicine Needed for the Emergency Care Service.

People who walk through the doors of A&E do not necessarily need to be treated by an emergency medicine doctor, the authors said. Often they could be treated by a co-located GP, a pharmacist, a specially-trained nurse, or a geriatrician.

The authors said emergency care systems in England are facing their "biggest challenge" in more than a decade.

"Currently the system is overwhelmed by the demands upon it. Crowded and chaotic departments are dangerous for patients and demoralising for staff," the authors wrote.

Emergency departments are facing "unsustainable" workloads and a "lack" of sufficient staff, they added.

The report follows a summit held by the RCN and the RCEM where officials came up with key recommendations to tackle the crisis facing emergency medicine.

These include: A&Es becoming "hubs"; better education and training for staff; and a new culture of collaboration across hospitals and the NHS and a whole.

RCEM president Dr Clifford Mann said: "Exhortations for hospitals simply to increase the number of emergency physicians and nurses working in A&E are doomed to fail when there simply aren't enough doctors and emergency nurses to go round.

"The recommendations from the crisis summit are fundamental to providing effective patient care and must be implemented."

Janet Davies, chief executive and general secretary of the RCN, added: "The pressures on emergency departments are no longer just a feature of the winter, they are present all year round.

"Despite the best efforts and dedication of the staff, these pressures are affecting all patients accessing emergency care.

"These problems cannot be solved overnight and will require a system-wide approach to reduce the blockages which so often add to the pressures on A&E.

"The time for action is now. The RCN and RCEM have developed these practical recommendations to sustain the emergency care service. There can be no excuse to ignore this situation any longer. Patients deserve better."