The British Medical Association (BMA) has predicted that the NHS may be about to experience its worst ever winter crisis, as more than 1 million NHS patients could face long waits in emergency departments. Following this, official figures have revealed that the target for A&E departments to see 95% of patients within four hours has not been met for four years now.
Winter months bring extreme weather conditions that affect almost every segment of our population – in particular, the vulnerable and elderly. Coupled with an ageing population which is developing growing health issues – such as and obesity and type 2 diabetes – the demands on our healthcare services and emergency departments across the country have never been so apparent.
It is clear that radical action is required to reverse the pattern of missed targets to prevent the crisis deepening further. So what are the options being proposed?
Some argue that these challenges require a public health response – helping people to make lifestyle choices to address health issues before they become critical.
But prevention doesn’t address the fact that there are record numbers needing emergency treatment now, on a daily basis. Experts say that at least another 10,000 beds are needed to help meet the current demand.
While both approaches are necessary and require urgent attention to address long and short-term factors, a simple fact remains – a significant proportion of those currently presenting to A&E departments don’t go on to require treatment. This places a major emphasis on improving triage so that patients aren’t spending longer in an emergency department than needed.
There have been some important advances in telecare and digital health platforms aimed at reducing the number of unnecessary A&E visits. But when people do arrive at A&E, they need to be seen, which means that A&E departments themselves need to identify at-risk patients as soon as possible.
This challenge is no more pronounced than when it comes to chest pain triage. More than 1.3 million A&E admissions in the UK are due to chest pain, and of these a significant proportion prove to have no serious cardiac-related condition. Yet currently the majority still go through the cardiac triage process which contributes to the factors that can clog up emergency departments and translate into potential treatment delays for at-risk patients.
When a patient presents at an emergency department with chest pain, traditional ECGs can’t conclusively rule out cardiac-related conditions, meaning that it can take a considerable amount of time and effort for NHS clinical staff to identify the real cause. A combination of examining medical history, physical assessment, ECGs and blood tests are required – this can take between 3 to 24 hours and still be inconclusive, and this current chest pain triage costs healthcare providers some £9 billion per year globally.
Innovative solutions need to be developed in order to resolve not only cardiac challenges, but other pressure points that will greatly relieve the strain on clinicians and frontline staff. There are a variety of robust research studies ongoing that have the potential to identify and develop potential improvements in cardiovascular medicine. We need to ensure that results of such studies are quickly utilised and applied to clinical practice as soon as possible.
As part of this, digital and technical innovations to aid clinicians in identifying and treating complex conditions need to be embraced, whilst encouraging innovation in the challenges of everyday emergency department pressures. Creavo are exploring the potential of MCG to help meet these demands. The use of MCG in emergency departments may provide a solution to ease overcrowding and allow treatment to be more efficiently targeted for those most at-risk.
Healthcare professionals and innovators across the world need to come together to help reduce patient waiting times to ensure that those most at risk of life threatening conditions are identified, prioritised and treated as efficiently as possible.