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Out-of-hours care needs to be made 'simpler', concludes NHS England review

The NHS in England needs to provide a simpler and more coordinated out-of-hours care system, NHS England has concluded in findings from its urgent care review.

The review, which has been led by Sir Bruce Keogh in light of growing pressures on A&E departments, said that many patients are confused about where to turn when they need urgent medical help and that is why they go to A&E.

Media reports - confirmed by NHS England this morning - say the review concludes there is ‘pressure’ throughout the system, not just in GP out-of-hours services but also walk-in centres, phone advice lines and in minor injury centres.

Another key issue was fragmentation and variation of service, according to the reports.

The review said: ‘The fragmentation and diverse nomenclature of urgent care services across England causes confusion amongst patients and healthcare professionals in terms of services offered. This can lead to patients presenting at services that may not best suit their needs.’

‘Urgent access to GP appointments across England is variable. Additionally, in urban areas where demand is high and transient populations exist, many may use an A&E department as their first point of urgent and emergency care.’

‘Most out-of-hours services work effectively to deliver a high standard of care to patients who need urgent care when their GP practices are closed. However there are variations in the standard of care provided and commissioners are not always able to hold providers to account.’

It added: ‘There is significant variation in patient experience between GP practices. Data shows that some patients who have a good experience of their GP are less likely to use A&E departments.’

The report also highlighted that the GP workforce has ‘insufficient capacity to meet needs’.

Click here to read the document

The report comes amid a lengthy row over who is to blame for the pressure on emergency departments, with ministers saying patients attend A&E because they lack access to primary care.

Further details will be released later today.

Readers' comments (3)

  • David Bush

    I hope, Sir Bruce, that your review will conclude that primary care services need to be resourced to expand. Do you have the strength to make this statement?
    Any other conclusion will be a fudge, and will not lead to any resolution of the current crisis.

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  • Similarly I hope, Sir Bruce, that any increase in primary care resource will be based on minimum numbers of appointments available by type per 1000 patients, or at least a review of practice level data.

    In some areas LMCs are still advising practices not to share this information, unwittingly or otherwise shielding the small minority of practices that give the rest a bad name....

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  • It's pretty simple already:

    If it's an emergency, dial 999 and they'll send an ambulance.

    If it's not an emergency, dial 111, and they'll send an ambulance.

    Simples.

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