The unpublicised limits on A&E

There is a problem in the Accident and Emergency departments in Britain and this is a problem which has been glossed over in the press.  I was absolutely amazed that the press have not picked up on this more than they have now that the information is in the public domain.

The problem is that each Accident and Emergency department has a limit to the number of patients it can admit before it suffers financial penalties.  If a patient is admitted and if they are within their quota then the cost of that patients treatment in the hospital will be funded.  If they go over their quota and admit a patient then the hospital only gets 30% of the cost of treatment for that patient.

There are also government rules on re-admission, there is a limit on how soon someone can be admitted to hospital after having been previously admitted to hospital.  If they are admitted within this time then the assumption is that their previous treatment was inadequate and the subsequent treatment is not funded.  But there are many patients with chronic and serious health problems who would have recurring problems whatever the quality of their treatment.

Think about this.  It is not as if the hospitals are empty and the doctors are admitting patients needlessly just to make money for their hospital.  Hospitals are usually full (over full in many cases), admitting someone who attends an A&E department is a serious matter, the patient is only admitted if they have a serious clinical need.

With this quota system it places an additional strain on doctors working in A&E when they have to take into account weather the hospital can afford to admit the patient.  The decision weather to admit a patient or not should be entirely a medical decision not a financial one.

I am not saying that there have been cases where a patient has been sent home when they should have been admitted to hospital purely because the A&E department was over it’s limit or if the patient had been admitted previously within the time limit.  But one could imagine a scenario where this might well happen.

How would you feel if that patient was one of your relatives?  How would you feel if that patient was you?