The NHS And Accident And Emergency (A & E)

Critically appraise a contemporary issue in health and social care and reflect on the implications this has for your nursing field.
This assignment will focus on three main points, the first being a contemporary issue that its relent to health care. The topic that has been chosen for this assignment is the NHS and accident and emergency (A&E) ‘crisis’ as this is a major talking point not only on the news but also within government. The government response to the NHS and A&E ‘crisis’ will then be discussed, looking at policies implemented by the government, such as the four-hour target and whether these policies are of any benefit to the NHS and the staff that work within the NHS and accident and emergency departments or whether they are a hindrance
and actually only put extra pressure on the NHS and its staff. Finally, this assignment will reflect on how the NHS and A&E crisis along with the policies put in place impact on today’s nursing practice and the future of nursing.
Section 1 choose a contemporary issue and explore its relevance to health or social care
The NHS was born on 5th July 1948, when it was launched, by the then Health Secretary Aneurin Bevan (NHSchoices,2015), with the first casualty wards being developed into Accident and Emergency departments in 1960 (NHSchoices,2015). The NHS was originally based on three core principles, these being: that the needs of everyone are met, that it should be free at the point of delivery and that it be based on clinical need and not that of an individual’s ability to pay (NHSchoices,2015). NHS England, 2014 states that “Our values haven’t changed, but our world has.” Meaning that over the years the NHS has had to evolve to continue to be able to meet the new challenges that it faces (NHSchoices,2014).
An ever growing and aging population, a population that is living longer based on new technologies and medical research, combined with the evolving and ever increasing complex health needs of individuals who are presenting with more health problems such as obesity and diabetes (Medicportal,2016).These factors combined with the problems of bacteria becoming increasingly resistant to antibiotics due to patients not completing the prescribed course or following medical advice properly, the closure of local services and budget cuts (Medicportal,2016) mounting deficits and worsening performances all combined with declining staff morale (Kingsfund,2015) means that the NHS is now facing its biggest challenge in recent history (Kinsfund,2015).
One area of the NHS that is being particularly affected by the ever increasing demand of today’s population is the Accident and Emergency departments (A&E) Which in turn means that many NHS trusts now have an A&E department that is in ‘crisis’ which in turn is having a knock on effect across the whole hospital, community and NHS system.
As accident and emergency departments are the first port of call for many patients that arrive in hospital, it is vital that A&E staff ensure that all patients are diagnosed correctly and efficiently. It is also vital that all patients are treated correctly before being sent to the correct are of the hospital for the duration of their care, (The College of Emergency Medicine 2013). Therefore, a poor A&E department will have a negative impact for the entirety of a hospital, (The College of Emergency Medicine 2013).
BBC: Hospital 2017 rightly points out that accident and emergency departments are expected to deliver “round the clock care” and with a 10% increase of service users in the last 10 months that means that on average accident and emergency departments are seeing an extra 150 patients a
day.

Section 2 consider the government response to this issue
In 2001 the Department of Health introduced a reform of emergency care.
This saw a first steps to a new approach which set out to improve the patient experience of the NHS (DoH, 2001).
One of the steps set out by the Department of Health, 2001, was that by 2004 no-one attending Accident and Emergency would wait longer than 4 hours from the point of arrival to the point of discharge or admission to a
bed.