Star comment: Poor A&E stats point to solution
For staff working in Shropshire's accident and emergency departments, trying to cope with the workload must be rather like trying to turn back the tide using buckets.
Their reward for heroic effort is to be beaten about the head with statistics which accuse them of doing an inadequate job.
The A&E departments at the Princess Royal Hospital in Telford and at the Royal Shrewsbury Hospital have been ranked 29th in a list of the country's 30 worst-performing emergency centres.
They are supposed to meet a target in which 95 out of 100 patients is treated within four hours. Instead, a quarter are having to wait four hours or more.
Anyone who has been to A&E can tell that they are doing their best. Why are they failing to meet targets? Because they are so busy. Why are they so busy? Because patients are flocking to them in large numbers despite continual pleas for them to explore other options rather than going to A&E as the default.
So it is the patients to blame, which is about as useful a conclusion as Basil Fawlty's idea that it was the guests that upset the smooth running of his hotel.
We need to take a step back and assess honestly the implications of what is happening. The exhortations to people to avoid using A&E are proving about as effective as exhortations to people to walk to work rather than drive. People are using A&E because they want to. It is the perfect fit for the way modern people live their lives – treatment on the spot, on demand.
This "problem" can be addressed by yet greater efforts to try to convince them to change their naughty ways. But why wil patients tomorrow listen when patients today do not?
Or it could be addressed by recognising the significance of people voting with their feet, and either investing in A&E or alternatively in minor injuries units which could effectively deal with the bulk of the A&E workload.
Shropshire's much-delayed Future Fit programme has canvassed the idea of having urgent care centres around the county. These "A&E-lite" centres could be the way forward in easing the pressure on Shropshire's A&E services.
If the Future Fit process is to come up with the right answers, it has to see the health landscape as it is. These A&E figures are no doubt meant to be a sort of league table of shame. In fact, they are useful data about what is needed, where, and on what scale.
