Urgent Care: Improving Patient Flow

Exploring patient flow trends within the hospital urgent care system.

Manchester Conference Centre – Thursday, 21st September 2017

The NHS continues to make headline news as it struggles to meet demands amidst the realisation that extra funding will not be forthcoming. Whilst the whole system is under pressure it is perhaps felt most profoundly in urgent care, more specifically accident and emergency departments of acute hospitals. However, the demand for urgent care arriving at a hospital’s front door and the patient journey from there on, creates and compounds difficulties in respect of maintaining a good flow throughout the hospital system right up to the discharge process.

As part of Open Forum Events’ health and social care portfolio, this year’s annual urgent care conference Urgent Care: Improving Patient Flow will focus on measures that can alleviate the congestion and successfully restore dynamic flow.

Open forum Event

The most recent Accident and Emergency Statistics publication shows that there has been a significant rise in the number of people attending A and E departments, despite constant efforts to reform the system and relieve some of the pressures by signposting to other areas of healthcare provision. The increase in footfall has had the knock-on effect of patients having to wait longer to be seen. This is the point at which good patient flow becomes compromised, as illustrated by a fivefold increase, over the last five years, in the number of patients waiting longer than 4 hours to be admitted as inpatients from the A and E Department.

Good flow requires space and in the case of a hospital this means beds. Over recent years bed occupancy has increased and coupled with an increase in length of stay as a possible consequence, the speed at which patients can be assessed, treated and discharged is delayed resulting in gridlock. Delayed transfer of care at the discharge stage further curtails bed capacity, as those medically fit to be discharged cannot leave the hospital due to a lack of an onward care package being in place or the absence of other necessary provision.

Some of the answers in overcoming the challenges in patient throughput lie outside the hospital environment. Reducing the attendances to A and E and expediting timely discharge can be greatly influenced with services offered by primary, community and social care providers.

The Urgent Care: Improving Patient Flow conference agenda has been developed to explore the current patient flow trends within the hospital urgent care system. Delegates will gain a greater understanding of how the problems occur from the start of the process, with the patient having attended the A & E department, through to the discharge process, returning back into the community and home. Our line-up of expert speakers will provide insight, opinion and stimulate debate as to how to relieve the burden on hospitals and reduce the pressures of compromised patient flow. We will showcase a number of initiatives and examples of best practice from throughout the health and social care system and there will be ample opportunity for interactive discussion and networking amongst fellow professionals and peers.

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How is the NHS in England currently funded?

The NHS is funded mainly through general taxation supplemented by National Insurance contributions.

While the NHS is generally described as being ‘free at the point of use’, patients have been required to contribute towards the cost of some services (eg, prescriptions and dental treatment) since 1951. Exemption arrangements are in place that cover many patients, including those aged under 16 or 60 and over, as well as recipients of specific state benefits. The exemptions in place resulted in 90 per cent of all prescription items in England being dispensed free of charge last year (Health and Social Care Information Centre 2016).

NHS England

The relative contribution from each of these sources of finance – general taxation, National Insurance and user charges – has fluctuated over the years (see Commission on the Future of Health and Social Care in England 2014b). For example, the proportion of income from user charges, from a high of 5 per cent in 1960 remained at 1.2 per cent between 2007 and 2011 (Hawe and Cockcroft 2013).

Across the UK, private health insurance policies are held by 10.6 per cent of the population. Most of these are corporate subscriptions, offered to employees as part of their overall remuneration package (LaingBuisson 2017).

More detail on specific funding

Source: Helen McKenna, Phoebe Dunn, Emily Northern,
Tom Buckley – The Kings Fund