Sir Bruce Keogh’s anticipated review into accident and emergency has been published today to a chorus of praise and boos. The Mail describes it as a ‘sticking plaster’. The Independent is cautious. The Guardian is critical. And the Telegraph and the Sun are more positive.
Sir Bruce Keogh gave a masterly performance on the Today programme, which may go some way to calming fears in the press. He said that the current system, which was designed in the 70s for the 70s, is unsustainable. At the root of his analysis is the belief that the present system is inefficient because patients have to go to the NHS to receive attention, rather than the NHS reaching out to patients. So, in short, emergency care has to become more flexible and mobile.
Some of Keogh’s figures are striking. 40 per cent of patients who rock up at A&E need reassurance rather than attention, he said. To tackle this, Keogh recommends ‘beefing up’ the controversial NHS 111 line by giving it the resources and personnel to provide better clinical advice, while at the same allowing staff to fix appointments and call ambulances when necessary – both of those proposals were suggested by disgruntled users of 111. Keogh also says that 50% of 999 calls for ambulances could be dealt with by paramedics at the scene or by local clinicians (GPs and pharmacists); so Keogh will encourage paramedics to make those judgments.
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