How to improve A&E - NHS is seeking your input! (UK Residents Only - though international ideas welcome via replies to this post)

How to improve A&E - NHS is seeking your input! (UK Residents Only - though international ideas welcome via replies to this post)

I've received a couple of requests from Matt Jameson Evans, the Chief Medical Officer and founding partner of HealthUnlocked for OUR ideas on how to improve A & E.

Sir Bruce Keogh wants your ideas about how we can improve Accident and Emergencies in England via the Urgent and Emergency Care Review

"Sir Bruce Keogh, Medical Director of the NHS, has blogged today in HU about his plans for making a ‘two-tier’ A&E in England with some ‘super-A&E’s’ for more serious emergencies.

It’s the first time any senior figures in the NHS have opened up ideas directly in a patient-focused network like ours, so I’m reaching out to you because we hope it can be the first of many direct engagements.

It would be great if you could quickly comment and make sure he knows you are from CLL Support Association. We have been told they are very interested in input from patient organizations and will take notice of the comments (no guarantees though!)

Have you visited an A&E or do you know someone who has? What are your thoughts about quality?

This is an important opportunity to give feedback directly to senior figures at the NHS."

Let your ideas on how to provide a better service take flight by providing your input via the link below, NOT by replying to this post.) [This link is to a post to the "I ♥ NHS community" which you can reply to as you do here - Neil]

Overseas members may like to share their good and bad experiences of their country's Accident and Emergency performance by replying to this post - perhaps that might develop into a good idea that a UK member can submit?

Please make the most of this opportunity. Our health status can change quickly and a responsive and effective A&E can be a life saver. In Australia, we too are facing the challenge of funding an increasing demand on A&E services, which is not helped by the time it takes to get into a GP, a situation further put under stress by the number of 'baby boomer' GPs now entering retirement. It is getting to the point where you have to schedule being ill to fit in with available appointment times - or take your chances and attend your nearest A&E.


Silver gulls are very attractive for a scavenger bird. It amazes me how they manage to stay looking so clean. They also have extrasensory perception - just sit down with some fish and chips and a flock congregates around you from nowhere!

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4 Replies

  • Hello Everyone & thank you Neil for raising the debate here in our community.

    Now is an opportunity to discuss our interpretation of what this review may bring or simply share our own experiences as an individual ahead of us replying to Sir Bruce and the NHS. You can read more about the review here at NHS Choices:

    I have posted the below early reply to the NHS thread and welcome your thoughts here ahead of posting our collective thoughts


    Thank you for your post Sir Bruce.

    Before replying CLLSA would like to explore together your report to gain insight into how this may affect those living with the many varied challenges a cancer of the immune system may throw up along their disease pathway. As a cardiac patient myself and a CLL patient A&E is almost a second home, however I am based in Wales so cannot respond immediately with personal experience of the English system.

    This is an important issue for us as visits to A&E may become a part of CLL life for many due to disease progression, immune and treatment complications that require an urgent and focused response. The average age of diagnosis of a CLL patient is 72 our members also experience the challenges faced by the older generation too in gaining appropriate care,,

    We have posted your appeal for feedback to our members to our own community asking for our members feedback and I have copied /directed my charity colleagues to your questions too. I hope soon to be able to forward or post here the collective thoughts of the CLL Support Association.


    Trustee – Chronic Lymphocytic Leukaemia Support Association

  • From a colleague at the CLLSA:

    "I hope that Sir Bruce Keogh's review of A&E provision in the NHS ensures that patients with chronic conditions such as CLL are treated appropriately and effectively in what ever provision is made available in a reviewed structure. My personal experience as a CLL patient has taught me that the current provision i.e. GP visit and/or referral to A&E is dependent on the level of understanding of the individual doctors or nurses of a specific chronic condition. On two occasions, the seriousness of my developing infections have been underestimated by GPs and doctors in A&E to the extent that I have become seriously ill, requiring stays of 7 days or more in hospital.

    I think it is vitally important to ensure that the individual professionals involved in triage arrangements in any emergency provision are aware of 'exceptional' conditions which should immediately prioritise patients for attention. There are many conditions that would require such additional attention but my concern is for the CLL community who are immuno-compromised with all of the problems and issues that this involves. CLL patients need to be treated urgently and aggressively if they are to avoid life threatening complications. However because CLL has traditionally been regarded as an old person's condition and as one of the 'good' blood cancers, it's seriousness can be underestimated."

  • PS Please All, if you wish to comment on this review and share your thoughts, observations and personal experiences in this thread, put them down. You may make a difference.


  • Feedback from NHS

    "Reflecting on what you’ve said: a message of thanks to HealthUnlocked members

    A couple of weeks have passed since launch of our Urgent and Emergency Care Review end of Phase 1 Report. So, I wanted to thank all of those people who took the time to respond to the first blogs from both Sir Bruce and myself which accompanied publication of our report.

    Thank you too for sharing your personal experiences of the current system – some good, and some bad. From reading your words it is clearer than ever to me that this Review is much needed.

    When you boil our Report down to the key points what we really want to achieve is quite simple.

    For those people with urgent but non-life threatening needs:

    - We must provide highly responsive, effective and personalised services outside of hospital, and

    - Deliver care in or as close to people’s homes as possible, minimising disruption and inconvenience for patients and their families

    For those people with more serious or life threatening emergency needs:

    - We should ensure they are treated in centres with the very best expertise and facilities in order to maximise their chances of survival and a good recovery

    I was struck when reading your comments how closely the issues you have all raised tie in with these two key themes.

    We absolutely have to do more to help people navigate the current system, so that people with urgent care needs to get the right advice in the right place, first time. We hope that work we are doing with colleagues in NHS England about developing 111 will help us get there.

    Access to treatment in the community is clearly a live issue from what you have told us. Providing faster and consistent same-day, every-day access to general practitioners, primary care and community services such as local mental health teams and community nurses for patients with urgent care needs is clearly very important to you. You are right in identifying that we need to be clearer around issues such as the facilities and services offered in the community, and opening times, if we are to be able to offer people the care they need as close to home as possible.

    Mental health crisis is another issue which featured prominently in your responses. Similarly, alcohol misuse. As our evidence base for the Review shows these are really big issues that are at the forefront of our minds.

    Our proposals to introduce two levels of hospital emergency department – under the current working titles of Emergency Centres and Major Emergency Centres - generated lots of interest in your comments. You have raised some issues about what this means for you locally, especially in terms of concerns about travelling further for treatment and the impact on rural areas.

    We really do believe that if we can introduce a more networked approach to the delivery of urgent and emergency care then we can offer a high quality service for all. Establishing these networks in a way that allows the right kind of services to be offered to meet the needs of local populations is an important issue that we will have to work hard on during the Review, because we recognise that this is a key concern for you. We emphasised the importance of a “whole system” approach in our Report. And you recognised this too. Having the right blend of services close to home (e.g. in pharmacies, GP surgeries, and minor injury centres) is an important part of the solution.

    The team working with me on this Review have been busy over the past couple of weeks. You will no doubt have seen either myself or Sir Bruce in the newspapers, or on TV, talking about the Review. We were pleased with the coverage that it has got – which has been mostly measured and fair. The wider team have been working hard behind the scenes to get our Delivery Group up and running. This work will continue over the next few weeks, and we will be asking Delivery Group members to share their thoughts with you over the coming months.

    Thanks again for taking the time to read our work to date, and to share your views. They are really important to us and so please do keep commenting" .


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