Most of us would accept that at least in some parts of England the urgent/emergency care system is under considerable stress. The news is full of it.
Most of the sensible and responsible people who understand these things say there is no single simple cause; it is a problem with the whole system. Our NHS is actually (believe it or not) very efficient but some of that has been gained at the expense of resilience and sustainability – the system works well but at such high capacity that it does not take much for it to become unstable.
So we have a system going wrong and we are not confident we understand why, or how to fix it. Andy Burnham came up with a plan to address this:-
- Call in all 111 contracts for review.
These rely on using algorithms for triage with little clinical oversight
- Ensure all hospitals have safe staffing levels and prevent further job losses.
A recent HSJ survey revealed that over a quarter of Trusts are planning to cut the number of nurses over the next year and one in five plan to lay off doctors.
- Provide immediate support for social care.
Use £1.2 billion of the 2012/13 Department of Health under-spend (£2.2 billion)to shore up social care over the next two years (2013/14 and 2014/15).
- Halt the closures of NHS Walk-In Centres.
Await the review being conducted by Monitor of NHS Walk-In Centre closures and the impact of closures on the local community and the NHS.
- Review all planned A&E closures and downgrades.
Review using the very latest evidence of local pressures and ensure there is robust clinical evidence supporting the plans.
The alternative plan from Jeremy Hunt was:-
- Claim there is no crisis
- Hope we have a warm summer and something happens before winter
- Blame Labour
- Blame GPs, especially women
- Leave it to commissioners
- Errr that’s it.