Now official NHS advice says: Don’t go to A&E unless you’re dying
ONLY patients suffering ‘ lifethreatening emergencies’ should be treated in A&E, official NHS guidance now states.
Hospitals are on ‘black alert’ as the health service faces its worst winter crisis in 15 years.
With some people waiting up to 19 hours for a bed, and a patient arriving every 90 seconds at one A&E yesterday, the advice is for all but those with ‘genuine life-threatening’ cases to stay away.
This contrasts with a 2013 report by NHS England medical director Sir Bruce Keogh which said the work of an emergency department was ‘unbounded’, caring for problems of ‘all severities’.
The latest guidance, on the official NHS Choices website, was attacked by Britain’s top A&E consultant yesterday.
Dr Tajek Hassan, head of the Royal College of Emergency Medicine, said: ‘It seems NHS England have changed their advice, as I have never heard before that people should only come into A&E if they have life-threatening illness or injury. In my opinion, that is a poorly thought through piece of advice.
‘A patient does not know if their condition is life-threatening. If you hand back the judgment for to them to decide, and something goes wrong, that is a terrible state of affairs. It is not the way to run an emergency care system.’
Dr Hassan said Britain is facing the worst A&E crisis in 15 years.
Dr Mark Holland, president of the Society for Acute Medicine, warned this could be the NHS’s worst January on record as it struggles with a backlog of elderly patients occupying beds over Christmas.
Once routine operations start again, the beds will be needed and a bout of flu or norovirus could be a tipping point.
Between Christmas and New Year, every hospital in Essex was put on ‘black alert’, where ambulances have to be diverted to other hospitals, or the highest escalation level. Rotherham Hospital in Yorkshire, and Leighton Hospital in Crewe have been ‘on the cusp’ of a black alert.
A woman at Stepping Hill Hospital in Stockport was stuck in A&E for 19 hours over New Year before being found a bed. The trust was at 100 per cent capacity and asking only those with ‘lifethreatening’ cases to come in.
Nottingham’s Queens Medical Centre reported a patient arriving in A&E every 90 seconds yesterday afternoon, while Worcestershire Acute Hospitals NHS Trust closed four minor injuries units so staff could cover A&E.
A spokesman said the trust was ‘deploying staff where they can help provide the best care’. East Midlands Ambulance Service, which covers six counties, declared a critical incident on New Year’s Day after its busiest ever 48 hours. Other services had to help after it received about 1,000 calls more than usual.
Saffron Cordery of trade association NHS Providers said demand was at ‘unprecedented levels’.
The British Medical Association’s Dr Mark Porter said: ‘This is yet another example of how an overstretched NHS is failing to keep up with rising demand.’
A spokesman for the Stockport trust said the patient waiting 19 hours was cared for by medics.
An NHS England spokesman said: ‘ Accident and emergency departments have always primarily been intended for accidents and emergencies … it’s a statement of the obvious that A&Es cannot and should not replace mainstream GP services.’
A Department of Health spokesman said the NHS was ‘better prepared for winter than ever before’.
Patients whose condition is not ‘life-threatening’ are advised to call 111 or visit www.nhs.uk.
‘ That is poorly thought through advice ... a patient does not know if their condition is ’ life-threatening Dr Tajek Hassan, head of Royal College of Emergency Medicine