GP ‘inconsistency’ compounding dangerous A&E crowding, says trust

A review into emergency care deaths at a struggling trust claims a “lack of consistency” in primary care referrals is a major factor causing A&E crowding.

Royal Cornwall Hospitals Trust, a national outlier for long accident and emergency waits and ambulance handover delays, carried out a review into potential harm to patients from crowding in its emergency departments, which has been obtained by HSJ.

The review found that several factors, both internal and external to the hospital, were leading to long A&E waits. Among them was a “lack of consistency in referrals from primary care”.

It said: “Too many GPs or their deputies send patients to ED when they could safely be referred to [inpatient] teams and bypass ED altogether.”

The review also found the ED was often being used by multiple specialties “as their receiving ‘ward’, bringing more patients to ED who do not need ED care”. This was particularly the case ”when [the specialty’s] own unit closes due to their opening hours, staffing or number of patients in department”.

Another factor was a “lack of provision of extended opening hours, staffing and radiology support for key [minor injury units and urgent treatment centres] meaning flow increases to ED in the evening”. The review also said there were “poor comms” when these services close.

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Source: HSJ, 21 November 2024