UK – The Impact of A&E Closures on Patient Wait Times

Upholding the quality of patient care has been the primary focus of the UK’s health care system since its establishment, but in recent years, data from NHS trusts have told a different story. Reports are published in an effort to provide both transparency to patients who rely on the system and accountability for the providers, staff, and government powers that are entrusted with maintaining a quality health care environment.

The latest report, focused on wait time targets, offers more in the way of transparency than it does accountability for certain departments operating under the umbrella of the NHS. Accident and emergency units (A&E) missed the mark on the four-hour wait time target in July by 5% which represents a consistent shortfall in providing timely patient care for the last two years running.

A&E unit target wait times were put in place to push the quality of care received by individuals seeking urgent medical attention forward. However, nearly 10% of patients waited more than the maximum four hours to receive a diagnosis, treatment, and eventual release from the hospital.

Accident and emergency unit NHS

Accident and emergency unit NHS

One A&E department reported missing the target wait time for nearly 16% of patients – a statistic that is a grave cause for concern among patients, providers, and advocates in the health care community. But the NHS seems to be focusing its efforts not on improving patient wait times but instead reducing costs where possible.

Closures around the Country

Target patient wait times were initially established in an effort to improve the experience individuals had when visiting an emergency department for mild to severe medical conditions. But the influx of patients to A&E units throughout the country has put undue pressure on the system, making it difficult to keep up with patient demand.

A nearly 3% increase in the number of patients seeking medical attention at an emergency unit has taken place in the last year alone, and the projections for years to come indicate more upticks over time. Instead of expanding A&E units through NHS trusts, a five-year program based on sustainability and transformation plans for the health care system focuses on two dozen closures of emergency units in various regions.

The intent of the department closures is first and foremost expense reduction. By transitioning patients who would have visited an A&E unit to primary and specialist care providers, authorities in health care believe that a decrease in cost will take place and subsequently, wait times at units that remain open will improve.

Part of the drag on wait times is the fact that all patient care needs are sought out through A&E units, from small issues to severe, urgent medical conditions. If hospitals are able to focus on only those illnesses or injuries that require immediate attention and minor issues are treated at primary care facilities, the amount of time a patient wait times for diagnosis and treatment will be less than under the current system.

Patient Impacts

In theory, improving wait times by transitioning care to a more GP-focused model makes sense. However, some are concerned that the exact opposite may ultimately become the reality patients face. A solicitor from a legal firm that deals with several Accident &Emergency negligence claims explains that multiple factors are in play that may be overlooked by the authorities creating and implementing NHS reorganisations, including A&E closures.

The number of patients receiving medical care has increased steadily over the last five years, but little has been done to ensure quality care is available once a person has been treated and released. Without after care solutions, bed-occupancy rates are at an all-time high which then leads to increased wait times for new patients coming in the door. This vicious cycle does not have an end under the current system and certainly does not bode well with the upcoming closure of current A&E units throughout the country.

When patients are met with lingering wait times, medical conditions can get worse, and the anxiety that comes with not knowing what’s medically wrong can be debilitating. While the NHS’ plans to cut costs through closures and downgrades of current A&E units is admirable from a balance sheet perspective, the move may not have a positive impact on targets for patient wait times in the short-term.

The healthcare system may need to focus its efforts on creating a sustainability and transformation plan that includes all aspects of care, from diagnosis and treatment to patient release and after care, if it wants to improve the experience patients have moving forward.

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