System wide action needed to better manage A&E demand

The Care Quality Commission has published new guidance, gathered from its inspections of emergency departments, which states that new ways of collaborating across the whole health and social care system are needed now to ensure that next winter is different.

Presenting the findings from inspections of emergency departments over winter 2017/18 alongside the findings of workshops attended by over 70 frontline clinicians aimed at understanding the issues facing staff and what needs to change, Under pressure: safely managing increased demand in emergency departments features practical solutions from frontline staff that can be used to help maintain safe services when faced with surges in demand.

Furthermore, the CQC calls for wider action by the whole health and care system to ensure a joint approach to managing the capacity problem as demand continues to grow. At present, 50 per cent of urgent and emergency services are rated as requires improvement or inadequate overall and eight per cent of urgent and emergency care services are rated inadequate for safety.

The reviews have raised concerns about the timeliness of this planning and the extent to which all partners across the system are involved in the planning process, with independent social care providers and voluntary, community and social enterprise organisations often less engaged. The discussions at CQC workshops have however generated a number of practical solutions to help mitigate risks to patient safety in pressured emergency departments.

Professor Ted Baker, Chief Inspector of Hospitals at the CQC, said: “So that we can understand the issues facing emergency departments and can support improvements, we have worked with frontline staff from hospitals across the country to help understand barriers and support change. These discussions have generated a number of practical suggestions that we’ve shared in this report, with examples of where they have been effectively applied, that can be used by others to help maintain safe, high quality care in the face of operational pressures.

“But these practical suggestions are only part of the answer. Hospitals cannot work alone to address the ever increasing demand on services - there has to be a system wide approach with all parts of the health and social care system working together to find solutions. We cannot accept that each winter will be worse than the one before – we are already seeing the impact on both patients and staff.  It is clear that what used to work doesn’t work anymore - new ways of collaborating and planning for surges in demand need to happen now to ensure that next winter is different.”