The NHS Alliance welcomes today’s report from Sir Bruce Keogh, New blueprint for urgent and emergency care across England, and is encouraged to hear that he does not believe that there is a quick fix or immediate solution to creating excellent urgent care services. We agree that this will take a lot of time and hard work, and everyone will need to show commitment over the next three to five years, and not just the next six months, if we are to really to improve urgent and emergency care services across England.
We are also pleased to see that Sir Bruce Keogh explicitly mentions dissolving traditional boundaries between hospital and community-based services, as the Alliance called for the exact same thing in March this year in our manifesto for primary care, Breaking Boundaries: nhsalliance.productionserver.co.uk/manifesto. We strongly believe that there needs to be more integration between primary, secondary and community services, and it is encouraging to see that there is mention of broadening care to include nurses, pharmacists and the wider community team.
There are major challenges in making the changes required. We need to trust local leaders working closely with their communities to explore what will work best, with the freedom to adapt centrally directed initiatives such as NHS 111 so that they are more flexible and avoid directing more patients to hospital.
Direct booking of appointments in general practice may make sense but will require a major shift in the way most practices work. Similarly, too great a focus on same day access in general practice may actually make things worse rather than better – we need to ensure that as patients we can get an appointment when we need one, which is often two or three days ahead, rather than a same day appointment being the only option. Small improvements across thousands of practices will have a greater impact than too great a focus on the pressures in A&E.
The NHS Alliance’s report, released in November 2011, ‘Breaking the Mould without breaking the system: new ideas and resources for clinical commissioners on the journey towards integrated 24/7 urgent care’, provides a whole system perspective of urgent and emergency care for clinical commissioners.
NHS Alliance is the leading independent voice for primary care, bringing together patients, frontline staff, providers and commissioners bound the common values of the NHS. Its core purpose is to work collaboratively to improve health care within a sustainable NHS, facilitating new and better ways of delivering services through its networks and campaigns. It welcomes patient-focused organisations and individuals of all disciplines, representing them to government and its agencies to influence policy in the interests of all its members.