The political and public pressure to tackle inadequacies in the delivery of emergency care is mounting daily. Politicians, academics and practitioners are all offering their opinions on causes and improvements – but how can we really know which of these suggestions, or combination of them, is the root of the problem, and what will solve the problems?

Introduction

Emergency care, by its very nature,has a massive variation in range of patients, and the severity of their conditions. Patients first come into contact with the emergency healthcare system through a range of routes. Problems in the ED are often a symptom of the pressures on the overall system, where a peak in demand or a lack of capacity in one service may cause a knock on impact elsewhere. By taking a whole system view to the issue rather than simply trying to optimize a single department, solutions will be more effectively implemented.

The reality is that teams in the healthcare system need to know what will make the greatest impact now, and plan for improvement over the future months and years. So how can they assess the entire system and all of the possible suggestions with so much urgency and pressure?

The suggestions

SIMUL8’s Healthcare team has taken part in a full review of the news articles and academic evidence and has provided a brief high-level overview of the competing and complementary theories on how to improve the whole emergency care system. These include:

Patients

• There are too many services to access
• outside of hospitals
• Patients need help to self-diagnoselevel of acuity of need
• Services need to be convenient to access
• We need better management of the aging population who are increasingly living with long term conditions