Create A&E hubs to stem emergency crisis, RCN says

A report by the RCN and Royal College of emergency Nursing (RCEM) has advised on the creation of accident and emergency (A&E) hubs that can deliver services to alleviate demand on emergency care.

The Medicine needed for the Emergency Care Service recommends that different approaches were needed to tackle A&E pressures, which is currently facing its biggest challenge in over a decade.

The report examined solutions to coping with increasing A&E attendance rates and highlighted that the attendance rate was outpacing the growth in emergency doctors and nurses.

The suggestion to group primary care services together was one of three recommendations put forward by the RCN and RCEM. In addition it advised that patients should have access to GPs, pharmacists, specially trained nurses and geriatricians.

The groups warned that despite previous attempts to curb A&E attendance it would be wiser to plan services in a way that took into account the ‘reality of higher attendances and admissions’.

The report said: “Only by training, recruiting and retaining the right number of staff with the right range of skills can we meet the needs of an expanding and ageing patient cohort.

“At present there is inadequate funding for education and insufficient resources to facilitate time away from the clinical environment to conduct training in the workplace. As a minimum, local joint training sessions are vital to increase training time and foster teamwork.

Dr Clifford Mann, RCEM president, said: “The need for an effective strategy to increase the nursing and medical workforce to meet the demands on the emergency care service is now urgent.

“Exhortations for hospitals simply to increase the number of emergency physicians and nurses working in A&E are doomed to fail when there simply aren’t enough doctors and emergency nurses to go round.

Dr Mann said: “The recommendations from the crisis summit are fundamental to providing effective patient care and must be implemented.

Janet Davies, RCN chief executive and general secretary, added: “The pressures on emergency departments are no longer just a feature of the winter, they are present all year round.

“These problems cannot be solved overnight, and will require a system-wide approach to reduce the blockages which so often add to the pressures on A&E.”