A senior figure at NHS England has suggested that Jeremy Hunt, the Secretary of State for Health is considering a “talk before you walk policy” for all presentations to the Emergency Department in the NHS in England. Patients would need to either see their GP or call 111 before attending A&E.
The comments have provoked a backlash, and both the Department of Health and NHS England have denied the plans to pilot such an approach. NHS England is seemingly divided and in disarray about how to deal with the sustained and severe pressure the NHS is currently facing. Contingency plans for another difficult winter have been criticised with the promised help of an extra £100 million funding, described as a “sticking plaster” by the RCN. Alongside all this, has come the announcement of a 10,000% rise in the number of patients waiting 12 hours in Emergency Departments since 2012.
In 2012, only 15 patients suffered a “trolley wait” of over 12 hours; by last winter the figure had risen to 1,597 patients a year. Drives to ration healthcare and prevent patients accessing the services they need have become increasingly common in the NHS.
Referral management systems have become commonplace in the NHS. Referrals from General Practitioners to Consultants can be screened, and can be rejected by a panel of administrators. These systems have previously been criticised by the BMA as being unnecessary and “performance seems to be related to blocking referrals rather than patient care.” Attempts to delay, divert or dissuade patients from attending move the pressure around the system, storing up problems for later and placing greater burdens on other areas that will also be stretched beyond capacity. Extra barriers make the NHS harder to navigate, particularly for the frail, infirm and unwell.
Alongside these barriers the wait for many services are increasingly. Labour MPs have recently highlighted the current wait for autism diagnostic assessments are often over two years, yet national standards say these assessments should take place within three months. The Labour Party needs to ensure that the disastrous failings of this government are highlighted and that the Party has a plan in place to ensure it is putting forward the practical solutions that health workers desperately need.