Thousands of UK patients visited hospital emergency units more than 10 times in 2012-13BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g98 (Published 09 January 2014) Cite this as: BMJ 2014;348:g98
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The appropriateness use of emergency department? We often encounter patients who attend A&E department frequently. Perhaps, as a junior doctor in four months placement, we all remember seeing the same patient again and again within that short period of time.
The recent move of introducing NHS direct 111 to reduce the admission rates of patients attending A& E department for non - emergency cases perhaps hasn't had much effect. We still see a lot of cases that shouldn't have come in through this department or even ended up as an admission to any specialities. For example, we still see patient who end up in medical admission unit for lower respiratory tract infection on a younger age group patient who is otherwise fit and healthy which could be managed by their GP in the community. Perhaps, NHS needs to consider a longer working hours for GP as patients often turn up in the emergency department after 5 pm where they have finished their works but their GP's surgery has closed. Also, NHS direct needs to be advertised widely to general public so patients know where to go to and ask for an advice for non- emergency cases.
NHS direct and GPs should identify patients who actually don't need any medical attention. For example, often we encounter patients who were admitted without any medical issues. The most heart sinking is we often has to put "acopia" in our diagnosis or impression. With the help of NHS direct and GPs to direct these patients to social worker will at least reduce the admission rates for this category of patients. Many times when we saw patients, they would said " I have no where to go, which is why I come to the hospital". Those patients might not only attend once but often become frequent attenders over months even years. If this continues, will NHS become more of social service provider rather that medical service provider? Perhaps, NHS might need to consider charging a small cost for service provision to patient to reduce unnecessary admission through A&E department? Education to general public is also paramount for public to understand the meaning behind Accident & Emergency department and what they are dealing with.
Competing interests: No competing interests