Measures to ease the crisis in A&E departments

SIR – The implication in Laura Donnelly’s interview with Professor Ted Baker, the new chief inspector of hospitals (September 30), that hospital leaders can act easily to resolve the crisis in Accident and Emergency departments, is unrealistic.

Either more resources need to be given to hospitals, or access to A&E needs to be regulated. As Professor Baker himself points out, measures such as “front-door streaming” may simply increase demand.

Building up community medical services and improving access to community social and residential home care would forestall some hospital admissions and allow other patients to be discharged sooner, thus releasing beds for patients waiting in the A&E department.

Ultimately, however, these measures alone will not solve the crisis. As the size of the elderly population grows, there will be an increasing number of patients who develop serious and complex conditions, which it will be difficult for community services alone to treat. Therefore, while hospital admission for some elderly patients can be delayed through better community care, more hospital capacity will eventually be required.

Demand on A&E departments could also be reduced by abolishing the four-hour wait target so that patients with serious conditions could be triaged to be seen quickly, while those with less serious problems could be asked to wait or to see their own GPS instead.

Beckenham, Kent

SIR – Dr Alan Drummond of Melbourne (Letters, October 2), who attacks the NHS for its A&E waiting times, should turn his sights closer to home.

Figures issued for New South Wales in December 2016 reveal that the target of a four-hour wait in A&E was met in only just over 70 per cent of cases: a Third World result compared with our own NHS.

London SE23