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Modernizing emergency units in UK

Introduction:
The health care system is among one of the basic needs of common mass. So, with increasing population the need of proper medical care is becoming a must. Governments of developed and developing countries are also trying to do their best to provide best health care system. But like every industry, health care service which is most important to live a healthy life is facing many challenges like funding, lack of motivation in stuffs who are associated with this service and many more issues.

Discussion:
Most injuries in UK are caused by vehicular accident, and are a major cause of disability and death. Every year, more than 3,500 people are killed because of road injuries while more than 40,000 are injured seriously (Department of Health, 1999a).  It is also forecasted that by 2020, injuries among young adults and children will supersede infections as a world burden of disease (Krug, E.G., et al., 2000).

    United Kingdom is one example of a developed country that has universal coverage to its constituents. Practicing devolution, U.K. has devolved its responsibilities on health care to its 4 countries. Funding of health care is brought about by national taxation, and has also devolved responsibilities to purchase for the National Health Service (NHS). Because of the universal coverage, usage of private medical insurance is very low. Only 11.4% of the whole population in UK enjoys a private medical insurance (Jemiai, N., 2005). However, a study conducted on how hospitals with A&E units in UK complied with the standards set showed that overall, the standards were not met. Most often the deficiency was not in the lack of health facilities and equipment, with the exception of inadequate neurosurgery units, but mostly it is in how health services were carried out. In a small number of hospitals, notable deficiency was on the failure to afford “emergency airway control or insertion of chest tube” (Browne, J. et al., 2006).

     Modernising emergences care are synonymous with making optimum use of available resources related to health care.  The most important point that the government should focus is on the capacities of the profession; to what extent the profession is ready to face the challenge.

 In an effort to improve quality of health care during emergency, the Department of Health has launched a strategy for modernizing emergency care in 2000. A year later more steps were added to expand the strategy (Department of Health, 2001c). In the Same year in October 23, 2001, the Department of Health also published a document entitled New Plans for NHS Emergency Care (Department of Health, 2001d). The document reported a £100 million strategy fund that is aimed at reducing the long waiting time in the A&E Departments for the next three years while eliminating trolley waits at the same time. It is projected that this initiative will lower the cancellation of planned operations by as much as 75%, since more general and acute hospital beds will be provided along with purchasing from the private sector additional medical operations. The initiative also aims to meet the 4 hrs target waiting time. According to Health Secretar Alan Milburn, (as Cited in Department of Health, 2001d) “Waiting is the public’s number one concern about the NHS. We are determined to tackle waiting in A ; E, whether that’s waiting to be seen by a doctor or waiting to be admitted on a trolley.”

In another publication from the Department of Health entitled New Measures to Speed Up Emergency Patient Care, the total waiting time to discharge or admission of 4 hours has been achieved in 90% of cases in the hospitals. This big improvement is relatively due to the utilization of the powers extended to health practitioners such as “nurses, paramedics, physiotherapists and pharmacists” in administering emergency care or medications even without the presence of a doctor (Department of Health, 2003e). In response to this concern the following can be done by health managers to modernize A &E unit

·           Conduct regular training of health personnel

o   Enhance the usefulness of training by carrying out a research that will exemplify best practices in the field. These best practices will be incorporated in further trainings and ensure that they will be accepted and applied. This way the A&E units will be more prepared to respond to emergency and accidents.

·          Implementation and use of Better Care for the Severely Injured manual which is enable emergency units to achieve a high standard of trauma care at UK.

o   This manual proves to be seminal in the improvement of care for the severely injured.

o   There should be wide implementation of these manuals

·          Emergency Preparedness in times of disaster

o   Health personnel and staff should be regularly trained on how to respond to disaster

o   Research can be done on best practices and integration of these best practices on all A&E units

·           Regular Evaluation of Health Personnel and Regular Feedback from Health Personnel and Patients

o   Evaluate Health Personnel on their performances; identify those who perform way below the standard set by the hospital and re-train those who consistently perform below the standard; or, immediate actions can be done if re-training does not remedy the sub-performance.

o   Elicit regular feedback from Health Personnel and get their views on how to improve the performance of the A&E unit.

o   Monitor any changes in the quality of health care at regular intervals (for example, monthly or bi-monthly or quarterly evaluation)

o   Inform patients and their families on the efficacy and effectiveness of the procedures you will be performing

o   Elicit feedback from patients on the quality of care given by the hospital; also ask feedback if the health services rendered to them are appropriate, not appropriate, lacking or best; get their opinions on how to improve the quality of health care they receive

But there is a difference between theory and the actual application of the theory. In the case presented in this paper, the approaches mentioned above are noteworthy, however, actual events would suggest that the realization of these approaches is not an overnight event.

Conclusion:
United Kingdom is a country that has successfully provided universal health care to its constituents. A UK resident can readily avail of almost all health services for free- something that is not afforded by other rich countries. However, this great system is not without a hitch. Problems on quality of responses in the A&E department began surfacing in the past decade. Modernization could be improved immensely if and when hospital managers, together with the government, harness political will in the implementation of its program. Health Care becomes effective when there is application of knowledge in actual practice and the critical challenge lies before the government to balance the process of modernization. If the professionals are put to challenges too far, they may lose the core value of medicine. If the jobs are divided as per the protocol so it becomes too clear who does what. Then the men would end up being “technical monkeys”, who provide drugs, the operation just keep the patient alive longer (Allen 1997). The basic challenge before health services for modernization of hospital service is keeping the men in high moral, committed and motivated (Kittson, 1996). The men involved in them should be caring and responsive to the demand of the public.

References

·         Browne, J., et al. (2006) ‘High Quality Acute Care for the Severely Injured is not Consistently Available in England, Wales, Northern Ireland: Report of a Survey by the Trauma Committee’, Annals of The Royal College of Surgeons of England Journal, 88, 2 103-107.

·         Department of Health (1999a) Saving our Lives: Our Healthier Nation, United Kingdom: Department of Health.

·         Department of Health (2003e) New Measures to Speed Up Emergency Patient Care, United Kingdom: Department of Health.

·         Department of Health (2001d) New Plans for NHS Emergency Care, United Kingdom: Department of Health

·         Department of Health (2001c) Reforming Emergency Care: Practical Steps, United Kingdom: Department of Health.

·         Krug, E.G., et al. (2000) ‘The Global Burden of Injuries’, American Journal of Public Health, 90, 523-526

·         Kitson, A. 1999, Does nursing have a future? BMJ. London.

 

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