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A&E – the ultimate magic trick?

The problem with a relentless focus on a single thing is that the real crux of the issue can often go undetected. As if by magic, with a simple sleight of hand, the attention is directed elsewhere, leaving those closest unaware as to what is really happening.

It seems that accident and emergency waiting time targets may be the perfect case in point with which to illustrate this rationale.

Last summer, the NHS was awarded extra budget to spend on primary care in the community, so as to alleviate pressure on A&E services during the winter months. It seems strange then that, in spite of this, emergency admissions reached the highest levels since records began in 2010.

Before Christmas 2013, the figure was at a staggering 105,000 admissions per week. Now this could simply be put down to an increase in more acutely unwell patients, or, alternatively, it could be a result of the rising pressure placed on A&E waiting times.

As more and more hospitals fail to meet the four-hour target, there are claims that patients are being admitted, regardless of whether they actually require emergency care or not, simply to ensure statistics conform to the recommended targets.

If true, this places an exceptional and unwarranted strain on the rest of the hospital system. More admissions equal a greater demand on already overburdened staff and resources, and with mounting pressure often comes declining quality of care and an increasing number of medical negligence cases.

However, hospitals claim that this is solely down to the fact that the most serious cases require substantially more detailed assessment and, as a result, are more likely to be admitted close to the four-hour mark.

Whilst this may be true of certain patients, it doesn’t fully explain why, once the deadline has passed, admission rates appear to fall dramatically.

The reasons behind the increase in emergency admissions remain unconfirmed, but evidence suggests that medical professionals may be making a decision influenced predominantly by time constraints rather than a duty of care. Ultimately, it could be that the controls the NHS has placed upon itself may be the very thing that causes its eventual collapse.

From the perspective of a personal injury lawyer with a particular interest in medical negligence incidents, I will be watching closely to see if there is any ‘sleight of hand’ in the gathering and presentation of these figures.

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