Ugent and Emergency Healthcare

I am a senior doctor working in Emergency Medicine and I'm looking for solutions for some problems with the "system" that have been around for a long time:

1 The system does not encourage fairness of reponse to healthcare need. Eg If you are referred in to hospital by your GP or another healthcare practitioner, the expectation is that you would be referred directly to a specialist and that the provision your care would be more effective and efficient. In reality this occurs randomly based on supply and demand on the service at the time at which you are referred: if the specialty you are referred to is very busy at the time of the referral you may actually be disadvantaged, compared with what would have happened if you had simply walked into the hospital and presented yourself. The system needs the ability to adapt to demand.

2 I believe all patients have the right to be treated equally based on their healthcare need, rather than time or mode of arrival into the system. Often it is difficult to immediately identifiy what that need is, however with a number of presentations decision support tools (eg an App) could guide the receiving healthcare professionals as to what tests they should be doing for whom (based on national and international guidelines and best practice). Early investigations lead to early decision making and therefore rapid treatment. This is more effective healthcare as well as more efficient (optimum use of scarce bed rescource) healthcare.

3 Often we are unable to access services in the community that are available to support patients at home. Sometimes that is because the service doesn't exist, but more often it is a result of not knowing who to talk to to get something done. I envisage a "fixer" role - individual or virtual network - that is available 24/7 to guide access to all services not immediately available in the hospital. This might be social support or medical support. Often patients get admitted because the clinicians are unable to access the required services at the right time. Admission of, particularly elderly, patients leads to increased risk from hospital acquired problems such as infection and a reduction in independence and mobility. 

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