Responsible patients improve emergency care

There is no doubt that emergency services are routinely on the brink of collapse. An increasing population has provided an unprecedented strain. The NHS was not built for its current demand. With increased diagnostic technology, more efficient treatment and effective public health initiatives, people live longer and healthier lives. With increased population size and longevity comes an increased use of emergency services. The distance between demand and supply is growing every day.

The recent junior doctors' strike heralded the first emergency care walkout in the service's history. Sensationalist mania swept the tabloid papers, urging people to avoid hospitals for risk of harm. Apart from being irresponsible, this behaviour contributed to an unexpected effect. As patients were more critical of their own need to attend emergency departments, efficiency within departments increased. It is completely possible that responsibility reduced emergency case burden and freed resources for the very sick. This is a positive change for which the public should be thanked.

There has been a movement in medicine pushing the public to consider whether their injury warrants emergency care. Issues like a broken nail or a simple cough can be seen by GP practices and, in the vast majority, will not require emergency treatment. The measure also appeared safe for patients, with no increase in mortality noted as a result of the strikes. It seems that patients are indeed sensible and knowledgeable, much to the distaste of the tabloids.

I am not suggesting that people tough out clear problems, but in a financially squeezed environment emergency care must be kept sacred. I would advise the use of non-emergency services where you feel safe to, and use 111 or walk-in services where unclear. Patients are experts in their own health, and can be given this responsibility safely. I have alluded to the growth of the 'expert patient' in previous articles, and I ask you to build on this concept. A phone call may save money, time and the NHS.

It should not have had to come to strikes to learn this lesson. But a lesson learned through strife is still of value. Let us work together to take responsibility as a nation for the delicate resource of the NHS. Let us help it grow, respond and thrive in the new demands of the 21st century. Doctors and patients must work together.


Ben is a young NHS doctor in the Southwest. His interests include neurology, health communication, and medical ethics. He is also an avid advocate of compassionate care and quality improvement, running a project in the Southwest around medical humanities.

The opinions expressed in this article are the author's alone. Where facts are presented, these are evidence-based. The author is happy to receive questions.

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