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Shaping the Future of Emergency Care

Family carer, Laura Collins

We all want a high-quality health service that keeps on getting better. We all want a more equal society where health inequalities are reduced. We all want the NHS to be there for us in an emergency.

Emergencies, by their very nature, involve unplanned health or social care treatment. This is known as ‘unscheduled care’ and includes providing support to patients in their home, urgent or emergency GP appointments, 999 ambulance services, emergency department treatment and discharge processes from hospital.

However, the ability of our health and social care system to provide unscheduled care every day of the week is becoming harder year on year.

Staff shortages, seasonal pressures and unprecedented Emergency Department demands are some of the many factors that are making delivery of an effective service more difficult. 

Over the past year, a regional network for unscheduled care has been actively working to resolve some of the concerns across our emergency and acute services, and there is now an opportunity for members of the public who have had experience of unscheduled care services within the past five years to bring an important patient perspective. 

You can be involved as a member of the Service User and Carer Reference Group to progress work in relation to unscheduled care, sharing your lived experience, and using your knowledge and expertise to progress work. 

Together, we can start to address the underlying issues, consider how to better spread the demand across services, and create a more effective and sustainable system through increased mutual understanding based on the principles of co-production.

Together, we can achieve the aim of getting the right patient to the right place at the right time, and to receive the right services. Together, we can make real and meaningful change that brings more timely access and better experience for everyone.

There will be a requirement to read documents, attend meetings every other month for a couple of hours, plus additional meetings as required, and to engage with wider service users and carers.  

For more information, click on or email or call 028 9536 3420. Completed expressions of interest are to be submitted by Friday 17 February 2017. 

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Previous comments ...

Geoffrey McBride 21-Feb-2017 at 09:35 hrs

I'm sorry to report that some ambulance men are not taking due care and diligence when they are lifting a person in and out of a wheelchair. The doctor from the hospital was absolutely fuming when he seen the abrasions under my wife's arms.


Doreen Patton 20-Feb-2017 at 17:55 hrs

I agree staff shortages and seasonal pressures have an effect on the delivery of unscheduled care but there are other major problems, reduction on the number of available beds, closure of EDs and residential beds, increased waiting lists and delays in elective care. To improve unscheduled care a whole system approach is needed. Physio and OT input in EDs may benefit a small number of patients and but is that value for money? The ED can only be as good as the service that backs it. If a step down service such as residential care which can be used for further rehab before patients go back to their own homes is not available hospital beds will obviously become blocked. GPs and primary care are not funded to provide the level of care needed for patients being discharged so quickly from hospitals now. Primary care needs to be GP led and less fragmented. Bring the GPs back into The NHS because the present system of contracts is not working. GP services have not got the funding and training etc that it needed for years. It is unfortunate that health care has become a nightmare for many of our elderly. The Northern Ireland unscheduled care pathway is now wait on a hard ambulance trolley in ambulance outside an ED where the engine has to be periodically running to provide heat, wait for hours in ED, wait for hours to get admitted because there is no empty bed, discharged early because the bed is needed, home without the proper support, a few days later back into the unscheduled care pathway. A review of staff roles is needed to get patients in hospital "back on their feet". In the past system of nurse training would have been more emphasis on the benefits of getting patients mobile and building the patients confidence up again. Nurses appear to view this as the physios' role. The physios do an excellent job but the nurse is there 24/7 and should be able to build on that work. We are all aware that nursing has changed but we are left with many gaps. How can that gap be filled and by who? How many managers plan their workforce on seasonal pressures etc etc. No part of unscheduled care is an island and can not be looked at on its own.


Brendan Clarke 14-Feb-2017 at 01:00 hrs

Major unspoken and suppressed factors in the pressures on A&E departments are Waiting Lists which lead to patients needing to attend A&E because they have not received the treatment that they need. Quite often I have been admitted to hospital from A&E, been patched up and subsequently discharged back to the waiting list for proper treatment ending up repeating the routine of A&E, in-patient, discharge to waiting list ending up......etc

A&E departments have been closed for being unsafe resulting that the remaining units are under so much pressure that they are becoming unsafe. The obvious conclusion is that they too will become unsafe and need to be closed leaving patients to fend for themselves.

Maybe Trusts should be required to make monthly payments to patients on waiting lists and patients pay for A&E visits.


Tom Sullivan 13-Feb-2017 at 16:32 hrs

Physiotherapists can relieve pressure on overstretched A&E departments. There is a scheme currently in operation in the Southern Trust

Numerous other examples can be found here at these links


Shelly 13-Feb-2017 at 15:11 hrs

I would be very interested in this topic , but only if the meetings are local.


Helly 13-Feb-2017 at 14:41 hrs

I heard recently, on Radio 4, that some trusts in England are separating elderly patients admitted to A&E. The are being treated in a different part of the hospital with staff used to dealing with elderly people. I think this is a good idea. Less stressful for the patients and their family/friends.