Shake-up of doctors' working patterns could slash waiting times at A&E, says expert

The experts say a simple change in how junior hospital doctors work is all that is needed to speed up assessment of the growing numbers of patients arriving at A&E departments. Our NHS Our Concern (ONOC) argues that waiting times could be halved by cutting out duplication.

It says that today patients are effectively assessed twice – once by junior A&E staff and then by specialist medics. ONOC’s report states that this wastes time and money and increases the time spent by patients in casualty.

Instead, it argues on-call junior doctors from different specialities should be based in A&Es, working alongside the junior staff. The think tank claims a similar structure is already in place for night work and junior doctors would benefit from better training as they would be involved in more stages of the clinical process.

ONOC is concerned by the prospect of A&E services being increasingly centralised.  It is feared that people without a car will face particular difficulties if more A&Es close in rural and deprived areas.

Sir Malcolm Grant, a former chairman of NHS England, said: “Many aspects of the NHS’s operations need now to be reviewed in the light of the Covid experience. It demonstrated just how adaptable and agile this great organisation can be.

“We must not revert to old habits once the threat recedes. We must lose nothing of the learning of the last year, and we must be willing to take on new ideas and approaches that will work better for our staff – especially our junior staff who we must do everything to retain and support – and our patients.

“To that end, I commend strongly the ideas in this paper for serious consideration.”

Professor Chris Moulton, former Vice President of the Royal College of Emergency Medicine, said: “Urgent and emergency care services are overwhelmed in many areas of the UK. This new model is one way of meeting the demand.”

Professor Parag Singhal, national secretary of the British Association of Physicians of Asian Origin, said: “Our think-tank Our NHS Our Concern is dedicated to finding practical ways of improving the NHS for the benefit of patients and for dedicated NHS staff. We draw on the experience of front-line NHS workers and they have helped us come up with this proposal – to boost the performance of A&E units by avoiding duplication.” 

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