Not Enough NHS Choices

After reading several articles and watching the news today it came to light one of the major issues with the NHS, and in the words of a top consultant its not about money or staff. he required more space to be able to treat more people.

So Money Means More Space?

So you may be thinking, well surely more money buys more space. The simple answer to that is no. The problem in reality is that the space available is being taken up by two types of people.

  1. Elderly – The elderly who have no onward care arranged and hence stay in hospital for longer than necessary, these are know as ‘Bed Blockers’. This title is a bit harsh on someone who has no other choice than to be in hospital.
  2. Minor Injuries – These are the people who attend the hospital particularly Accident and Emergency for minor ailments.

So as you can see simple from the 2 types of patients above the NHS is stretched, using more resources and man power to cope in areas they should not even have patients. Removing some of these patients means more space and resources to help people.

The Problem

I will concentrate on the second of the two types of the minor injuries and I will write another post dedicated to the elderly and their care needs later on.

Several years ago the government introduced different levels of NHS care and in particular the whole idea of self care for minor ailments and NHS direct if you need to speak to a health care professional.

To use this service you dial 111 instead of 999 and you can speak to someone about your problem.


Now the huge issue with this service is that, its a support service and requires other service for some of the outcome of the advice. Granted some advice will be very much self help, but in alot of case you require actual medical treatment.

What you mean 111 cant help me?

Picture the scenario. Its 7pm on Saturday night, a time when the hospital Accident and Emergency departments are getting busy due to weekend demand. You need medical advice about a minor issue so you call 111, as being responsible you know 999 is only for life threatening emergencies. After talking to the people at NHS Direct, they realise you need further medical assistance.

As it is now 8pm at night the options are somewhat limited, depending on what your issue is and as long as its not life threatening, the team at NHS Direct can either tell you to go to an walk in centre or if its an issue you can solve yourself and need something for they may direct you to a local medical centre to pick up something. However in most cases their only option is to refer you to the hospital and that means the Accident and Emergency department. Who we know at this time are busy dealing with tons of people.

NHS Choices are too Ambiguous

As you can see from the NHS chart, some ailments are pretty straightforward, such as headaches. However when you start moving up the scale to things like vomiting, sprains, cuts etc, it all becomes a grey area. The advice is contact your GP, but what do you do if your GP is closed. Some people call NHS Direct (who most likely direct you to Accident and Emergency) and some people just go straight to A&E.

Even the NHS themselves in their own guidelines advise on using a Minor Injury and Illness Unit or Walk in Centre. But what do you do if you don’t have one near by. Yep you guessed it go to Accident and Emergency.



The Solution

So what is the answer. Well the answer in short is kinda two fold.

More GP Surgeries Open Late

We need more GP surgeries operating longer hours, that way not only would people with none emergency issues be able to contact their own GP for advice and assistance, but the people at NHS Direct would also be able to direct you to a local GP and not to A&E.

This would require more funding for the GP surgeries, but its cheaper to fund a local GP surgery after hours than it is to fund a hospital Accident and Emergency unit. Meaning in reality we would get more services for less money than we are spending now.

More Local Walk in Centres / Urgent Care Centres

Part of the problem is we do not have enough local services in the UK, some big towns and cities  have walk in centres. These are in essence run by GPs and nurses and are open 24/7. Think of them as a mini hospital if you will, but without the huge price tag.

One solution to this shortage and provide the man power for these centres, would be to operate a rota system between GP surgeries in each area.  Rotating around being available 24/7. This way when you contact NHS Direct they can direct you to a local GP Surgery and not to the Accident and Emergency Department, and if the local GP feels you need to go to hospital after seeing you then you may actually need to go to A&E.

This would work the same way in some areas a local pharmacy is open longer making GP surgery hours. Operating on a rota between other pharmacies to allow patients to pick up prescriptions the same day.

A GP surgery 24/7 is much cheaper than a hospital.

In Closing

By operating more local services, we can cut down on the amount of demand for Accident and Emergency. Make it clearer for people as to which service they need for their problem. Removing one big issue at present as the choice is too ambiguous. Leaving a lot of people heading straight for A&E.

These solutions would require a move of services, but would bring huge savings as local services run correctly are cheaper and more effective than what we currently have. Which is not working.





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