Healthcare
NHS Corridor Care
“That is absolutely true. We need to look at all the ways of reducing demand on GPs and, therefore, on A&E departments—that is what my speech is totally involved in—and pharmacies have a really good role to play. There is another thing here, which was noticed in the doctors’ strike. When we have senior clinicians on the front door of A&E, that makes the department much quieter, because they make decisions quickly and can take a bit more clinical risk as they are more experienced. Perhaps we need to rearrange how care works in A&E departments so that we do not get a backlog. I turn to the remedies. We are beginning to turn the NHS around—that is clear from working in it and from what my patients say. Things are beginning to change. We need to do a lot more, but we are investing a lot of money in it. We must not say that things are getting worse, because I believe they are slowly getting better. As so many have said, we need to fix social care. We could have a system whereby the community is responsible for a patient as soon as they are ready for discharge. Perhaps the community should have to pay for the patient to remain in hospital after that to encourage it to get them out of hospital. We must stop agency working in social care, because that is causing a huge amount of stress to carers. We need care to be based on a community model so that carers cover small areas and do not have huge travel times. We also have to improve GP access. I think we should also make it so that A&E departments see only accidents and real, genuine medical emergencies. So we need a little bit of an increase in funding for primary care. We also need GPs to be assessing emergencies up until 10 o’clock at night to relieve the pressure on A&Es. There are a couple of other things. I have said about getting more experienced doctors involved earlier in the process, but we also need to invest in scanners—so many people in A&E are waiting for tests before they go home. Also, as my hon. Friend the Member for Tooting (Dr Allin-Khan) said, it is not appropriate to have mental health assessments in A&E; we need mental health assessment units, which I do believe the Government are bringing in. There are a few clinical factors. Perversely, we need not to be so risk-averse. For example, admitting a patient for risk of falling is ridiculous, because they are more likely to fall in hospital than in their own home. Dementia fluctuates, so just because someone has seen a slight increase in confusion, that does not mean that they need a whole batch of tests. We need to treat dementia more holistically. Polypharmacy—that is old people on loads of drugs—causes about 10% of admissions, so let us reduce that. We need good end-of-life care. Some 50% of people with cancer die in hospital—many of them face corridor care—and we need to reduce that, because most of them want to die at home. Every older person needs an advance care plan so that, when they become ill, we know whether they want to go to hospital. That is incredibly important in pathways of care. Corridor care did not appear overnight, and it will not disappear overnight. But, by rebuilding the NHS from the community upwards, fixing social care and investing where it matters most, we can ensure that no patient is left waiting for care in a hospital corridor ever again.”
