Rising cost of Emergency Admissions in UK
United Kingdom has universal healthcare – free at the point of need (paid for, of course, through taxes). This works well – people generally don’t suffer unnecessary pain, get back to work quickly, and those most in need (the very young and the elderly – for whom health insurance is generally prohibitively expensive) get the care they need.
But one of the most expensive parts of the system, the Emergency Department (Accident & Emergency or A&E in UK) is now becoming one of the most widely used – people know that they will be seen within 4 hours, which is faster than they will be seen by their Doctor, so they pitch up at A&E.
Care suffers – if what you really need is a good listening to, and some advice on diet and exercise, you aren’t going to get that in A&E. Costs suffer – seeing your GP costs NHS around £18 ($22), whereas turning up at A&E costs £70 ($98), plus any additional tests, and an admission could easily cost £1500 ($2100).
So what can be done about it?
A person's local GP is the decision point of this whole process. The GP makes decisions to send a patient to hospital, or to treatment closer to home: the right treatment is cheaper in the long term. Patients may be the experts on their own symptoms, but they aren’t the experts when it comes to deciding what is wrong with them and what treatment is appropriate (and this can end up as expensive and poor quality, as Porter & Teisberg illustrated in 2005 )
But Primary Care Trusts (PCTs – the local bodies set up to plan and pay for health services locally) aren’t always good at engaging with GPs – and in spite of the present government’s efforts , GPs are not going to ignore lessons learnt over a number of years (“David Nicholson doubts 2012 timescale for GP commissioning role”).
Money
Engaging with frontline healthcare professionals will be needed, if UK is to balance the budget The health service costs around £100billion ($146bn) to the tax payer, and unlike many parts of government spending, this sum is protected during the austerity measures. But we should anticipate that the government will expect more for their money – for example elderly care, currently paid for out of a social care budget, is likely to become part of health funding. Engagement is vital, and we must look for ways to achieve it.
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