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What happens in A&E

  • Last modified date:
    18 March 2004

Before a patient in A&E is admitted into hospital for further care, transferred or discharged, there can often be a lengthy chain of decisions, tests and treatment.

When delays occur at any or all of these stages - long waits in A&E can and do result. This area of work is focusing on reducing the amount of time a patient spends waiting for or receiving assessment, treatment and decisions in A&E.

Key target

  • By the end of 2004 patients will wait no more than four hours in A&E from arrival to admission, transfer or discharge.

Work in progress

Work is now underway to speed up the process of investigation and assessment of patients.

Some A&E departments have set up clinical decision units (CDUs) or have access to medical assessment units (MAUs) specifically to focus on these areas. But there needs to be better evaluation of their effectiveness and wider dissemination of the good practices they are identifying.

Other work is concentrating on:

  • Improving access by those in A&E to diagnostic facilities and equipment.
  • Improving pre-admission and assessment processes - looking at the potential roles of different professionals (senior doctors, nurses and allied health professionals).
  • Reviewing the care of patients who require more than four hours of assessment and treatment and providing guidance on where and how these patients should be treated.
  • Building up better information on why and where bottlenecks build up in A&E.

Future thinking

The Modernisation Agency's changing workforce programme is exploring ways to streamline the diagnostic process by using, for instance, radiographic assistants to carry out basic x-ray work.

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