Many times in the past year we have written about the casualty department at Queen Alexandra Hospital, and its worrying inability to meet waiting-time targets.
What has become clear over the past 12 months is that the pressure on accident and emergency is only going to be alleviated by all areas of health and social care working together. This isn’t just NHS jargon, or the modern practice of using the phrase ‘in partnership’ as a means of self-congratulation for all concerned – it is clear that casualty is bearing the brunt of, not failings, but what you could call insufficiencies in the rest of the health service.
For example, out-of-hours GP care, or even out-of-office-hours GP care is becoming rarer and rarer. Walk-in centres, for some reason, are ignored by large swathes of the Portsmouth area. And there are many elderly people who should be living in residential care but instead are in their own home with visiting carers. At risk of falls and other problems, casualty is often the first port of call, and with an ageing population, this is not going to go away.
In this context, it’s disappointing that the funding that sees GPs placed in the casualty department looks likely to be removed. The doctors and nurses in the Urgent Care Centre act as a kind of triage, freeing up the department to deal with the genuine emergencies – the victims of car crashes and the like, when every minute is crucial.
As the Urgent Care Centre has been seeing up to 35 people a day, it’s not a particularly bold claim to say it’s been useful, and that there will be unwelcome knock-on effects should it be removed.
The clinical commissioning groups that have funded it may have as-yet-unrevealed ideas about what to do with the money, plans that could be equally beneficial to QA. But it would be disappointing if this were a cost-cutting exercise.
The failures at A&E are important. They are a stain on the record of what in many other fields is a world-leading hospital. We’ve called before for a multilateral, wide-ranging approach to solve the problems, and we hope this is not ending, as it could literally be a matter of life and death.