ED workloads and wait times

Hi

the ED workloads are getting worse year to year. More and more are ringing ambulances and want to go to hospital often for things are not emergencies or accidents. I think the following things should happen:

1. There should be a 24 hour GP service that is on the hospital grounds and close to the ED. People who need GP services should sent to the clinic. And it should be a fee paying service. Too many people can't get to a GP or can't or won't pay the fees and end up clogging up EDs with non emergencies or calling ambulances as they think they can get thru ED quicker

2. Pharmacy meds - I think too many things require prescriptions from a GP when sometimes a pharmacist should be authorised to prescribe a medication, or a renewal. At present some people can't afford to go to a GP or can't get an appointment so they can't get a prescription and as a consequence their medical problem ends up getting worse or they end up having to go to ED. 
 

3. Resthomes - the standard of care in some resthomes is poor. some are really good, but some don't have sufficient qualified staff in hospital wings of rest homes so they end up having people sometimes transported to ED for things that should be treated in the community eg UTIs. Having to use ambulances and ED to deal with someone who has a UTI is a waste of resources when often a prescription of antibiotics would solve the problem. The system is ver inefficient. I understand there are audits dont by MoH /DHB of rest homes. These audits should be unannounced and maybe follow in an ambulance and see what the standard of care was like from the restome hospital wing

4. Review rights of practice for all medical professionals- too often approval to do an intervention falls on a GP.  There are some really good registered nurses, community care paramedics, pharmacists who may see the patient more often than the GP - so maybe they can prescribe meds or other interventions such as referrals to mental health services

hope these thoughts help. Yes the sector is resource constrained but at same time it isnt operating that efficiently and too much end falling back on EDs to sort out when health care issues could be dealt with elsewhere 

EDs are clogged. workloads for EDs and ambulances are blowing out and this winter the system wont cope. We can't cope in the "quiet" time of the year. There needs to be a fundamental review to look at how the system operates. We aren't going to find more doctors, nurses, paramedics over night(even if the resources were available and the pay higher) so there is a need to look at other options to make the system to work more efficiently so the EDs and ambulances are kept for real emergencies (as having resources tide up for low priority stuff means less ambulances etc are available for time critical responses and people can have bad patient outcomes as a consequence)