> The audit commission drew only two
> conclusions; the total number of patients attending has
> increased modestly in five years, and the number of staff has
> increased. They seem perplexed at the increased waits.
> One plausible explanation is a changed case mix. More people
> attending hospital are admitted, arguably an excellent
> proxy for a greater proportion being more ill.
Alternatively, it's a sign that we're admitting more patients
inappropriately (lazy AND incompetent).
> Seriously though, it's a scary thought;
> imagine when our
> waiting times are routinely under 75 minutes, demand will
> surely rise and
> rise inexorably pushing those times out of reach once again.
Depends on what we treat. If we restrict ourselves to accidents and
emergencies, there's a limited supply of those. The main worry for
increasing demand is primary care, but that's only a problem if you treat
non emergencies rather than referring back to GP (the alternative being to
bring primary care and A and E under the same umbrella to give more
equitable allocation of resources).
Maybe I misunderstand the report (and probably I'm representing an extreme
viewpoint), but one interpretation is it wants little nurse minor injuries
units/ drop in centers covering populations of under 100k, with A and E
departments seeing only the genuine emergencies (i.e. things that can't wait
over an hour).
Matt Dunn
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