Reform of 'emergency' or 'urgent' care

[Richard Berry]

Hi, this is Richard Berry, I am a Policy Officer at the Alzheimer's Society national office. I am hoping to get people's opinions on some new proposals from the Depertmant of Health to reform the way 'emergency' or 'urgent' care is organised.

This will affect out-of-hours GP services, emergency respite, Accident & Emergency departments, and so on. We would like the Department to listen to the views of carers and people with dementia while doing this. We have set out some key questions for you to think about – your answers will help us to make sure the changes benefit carers and people with dementia.

1. What experiences do you have of trying to arrange a GP consultation, prescription or emergency respite in an urgent situation?

2. It is proposed to introduce a new, national telephone number (different to 999) for people to phone when they need support urgently. Operators would arrange for local staff to assess your needs as quickly as possible. Do you think this is a good idea?

3. The Department of Health would like more people to use walk-in clinics instead of Accident & Emergency departments when they need care urgently but not for a medical emergency. Would you prefer to do this?

4. It is suggested that people’s personal care plans should detail the ‘steps to take’ in urgent situations of different types. What kind of things should be detailed in the plan?

Thanks for your help.

 

[Brucie]

Hi Richard

I really wasn't sure what I might post in reply, and the following may not be helpful, but, here goes:

1. What experiences do you have of trying to arrange a GP consultation, prescription or emergency respite in an urgent situation?

When Jan was at home and I was caring for her full time, the following were my experiences:

GP consultation - I arranged to e-mail my GP when I needed to bypass the Berlin Wall of the surgery receptionist. or to call his mobile. these worked for us on the infrequent occasions we needed them.

prescription - e-mail

emergency respite - for an early onset family... that is a major laugh. I once asked for it and they spent 30 minutes showing me around. "Great" I said, I need respite in two weeks as I need to go to a conference abroad. "Sorry" they said, there is a six month waiting list. Emergency respite is a trifle oxymoronic, methinks

2. It is proposed to introduce a new, national telephone number (different to 999) for people to phone when they need support urgently. Operators would arrange for local staff to assess your needs as quickly as possible. Do you think this is a good idea?

I needed to call the emergency services once, when Jan fell out of bed and bit clean through her lower lip, producing loads of blood. The ambulance came quickly and reassured me but would not take her in to the hospital ["wounds heal really quickly in this area" ... and they were correct; I called the GP in the next day].

I don't really care what the number I need to ring would be, just that the help could be organised. I think that 999 is the preferred number though. Why not provide another number for the time-wasters....

3. The Department of Health would like more people to use walk-in clinics instead of Accident & Emergency departments when they need care urgently but not for a medical emergency. Would you prefer to do this?

in my experience, hospitals are the last place people with dementia should go to - the staff have absolutely no knowledge of the condition outside the specialist areas. In my experience, the times we most needed help were those times when we needed help at home - it would have been impossible to get Jan in the car, let alone 15 miles to the hospital.

4. It is suggested that people’s personal care plans should detail the ‘steps to take’ in urgent situations of different types. What kind of things should be detailed in the plan?

Wishes for no resuscitation, understanding of the dementia condition in all its stages and in the different dementias. To defer to the better knowledge of the carer.

As in all areas medical, I'm not sure the norms for other conditions really map to the dementia area.