NHS England: A Call to Action
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Reflecting on what you’ve said: a message of thanks to HealthUnlocked members

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.


9 Replies

I hope that people with Ra and associated diseases are all seen in one clinic of excellence.Like psychio,mental issues arising from our diseases. It would make life easier for us all, and perhaps a meeting place or group that we could all meet to offer each other support and perhaps give guidence to the new patients.


I do think that local minor injury centres such as medical centres would take so much strain off the hospital A&E. Major Trauma centres carefully placed near Motorways etc. Widespread stroke and heart education to staff.


The more I read about Functional Medicine the more I think it is the way forward. Not treating the myriad of symptoms with drugs but searching for the underlying cause. Time for change - Western Medicine ain't working ! I am actually going to be doing a free on-line course - even though I am not medically trained ! When you have a complex medical history - and many do - they then go to see the Gastroenterologist - then the Cardiologist - the Endocrinologist - the Neurologist - not to mention the counselling - and the Gynaecologist. It is time to do joined up writing and there should be a clinic that covers everything. Consultants for this and that should not be allowed to hide away in their own little world. There are 89 known Auto-immune conditions and all these conditions invariably begin with LGS and Gut Dysbiosis. Western Diet is at the root of all this - so why not Auto-immune clinics run by Functional Medical Practitioners that can get to the ROOT cause and save the NHS TRILLIONS with all the endless searches - up blind alleys that do not lead to WELLNESS !

I was diagnosed with Crohns some 40 years ago - and had six-monthly checks. Not once was I offered guidance or advice on how to keep my gut healthy. I did it all myself and the books are still on my shelf ! I have saved the NHS thousands !

Food for thought !

It's also about time that Endocrinologists specialised in Thyroid as well as Diabetes. Time to think of diabetes as the end result of undiagnosed or undertreated thyroid....I could go on for hours ! - time to go !


I do agree with you about this - nothing seems joined up these days - I was tested endlessly for heart problems, and then for respiratory problems when it was clear even to me with no medical training that I needed these two consultants to get together and work out what was the root cause of my problems - it didnt help that there is no allergy clinics in my area and it is quite plain that allergies played quite a role.


More access to X-rays and diagnostics direct from GPs (or in ambulances?)! If the only reason you are at A & E is to be on the safe side in case you might have broken something, do you really need to go through the triage system etc?


We need to keep walk in centres, A&E and NHs Direct, We need rehabilitation programmes for those newly diagnosed with a chronic illness and those recovering from cardiac or other debilitating illness. Access to specialising consultants when needed, avoiding any possible misdiagnosis. All these things share the load of NHS services, fulfil the need of patients and provide a good health service.

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Keep walk in centres, we don't have any in my area lol, nearest is either 20 miles away or 40 miles the other way lol, would be great to have one in our town of Southport.

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Hi Philip, respond to the poster (urgent care review team) rather than me.. I can't do anything about your situation but the original poster may be able to - good luck.


We used a Minor Treatment centre yesterday that was attached to the Walk in Centre and my eyes were truly opened! There were so many people there that could easily have been dealt with by a pharmacist for colds and flu, and kids brought in just because they had a temperature. All of these took up the majority of the space and time. The kids that were bought in off the pitches were less than five and adults with sprains were in the same bracket.

We only used the system as my husband had fallen over the day before and his wrist had ballooned triple the size, so wondered if he had broken it. We explained we only went as in the summer he fell and broke his foot with a clean break and had been walking for a week before seeking treatment, as we thought it was a sprain! He is in his 70's.


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