There has been much in the press recently about the pressures being felt in A&E. Two weeks ago, I wrote about my own experience in A&E (which was excellent) and I think it is important that we remember how much great work continues to happen 24 hours a day, despite the headlines.
Much has also been written about the reasons why A&E is so overburdened and the hospitals so full. There is no single reason – there are multiple factors sometimes coming together to create a perfect storm.
The size of the population is considered to be one factor. There are simply more people living in the UK than ever before so, logically, there will be an increased demand.
People are living longer too, so the proportion of older people and with multiple health conditions is continuing to rise. There are now 10 million people in the UK who are over 65 years of age. This number is expected to grow to 15.5 million in the by 2035 and 19 million by 2050.
However, the evidence demonstrates that it is not older age groups that make up the majority of the A&E attendances: it is those of working age, with 70 per cent of all attendances by the 20 to 60-year-old group, often for minor illnesses. Those who attend A&E in the older age groups are more likely to have a major illness and to be admitted. The HSCIC has lots of information explaining the trends and the multiple factors which contribute to the pressures in A&E: www.hscic.gov.uk.
Greater access to GP services is one factor which would alleviate the pressures on A&E. Helping patients to understand where to seek help is also required, but then the services need to be conveniently located within the community for this strategy to work. The new service models proposed within the Five Year Forward View seek to address this with, for example, the multi-speciality centre in the community.
General practice nurses are in an excellent position to contribute to the new service models and I anticipate a much higher profile for nurses working in primary care throughout 2015 and beyond.