Urgent And Emergency Care: A PESTLE Analysis

Introduction

In 1942 a report by William Beveridge formed the basis of the Labour governments welfare state, so that healthcare would be universally available and funded from taxation. Identifying what he considered the major problems being ‘five giants stalking the land’, want, ignorance, squalor disease and idleness (Naidoo, 2015). As a result, on July 5th 1948 saw the launch of the National Health Service (NHS) by the health secretary Aneurin Bevan at Park Hospital in Manchester. To provide health care for everyone from ‘cradle to grave’ based on three core principles: to meet the needs of everyone, free at the point of delivery, and based on clinical need, not the ability to pay (Naidoo 2015). At present the NHS employs 1.2 million

Appendix 3.
Urgent and Emergency care is a service providing life-saving care (Keogh Review). According to the Francis Report (2013), high mortality rates among patients admitted as emergencies to Stafford Hospital, showed evidence of inadequate care which lead to a full investigation. As a result, medical director Professor Sir Bruce Keogh was asked by the Prime Minister David Cameron to conduct a complete review of the NHS urgent and emergency care system. It highlighted five key elements for change to ensure success:
1. To provide better support for self-care.
2. To help people with urgent care needs get the right advice in the right place, first time.
3. To provide highly responsive urgent care services outside of hospital, so people no longer to choose to queue in Accident and Emergency

However, measuring the proportion of people seen within four hours does not provide a full picture of how A&Es are performing. For example, two different A&Es could see the same proportion of patients within four hours but have very different average waiting times. In addition to waiting times, the quality of A&E care can also be measured through patient experience surveys and clinical indicators such as the proportion of patients who re-attend A&E within seven days of their first attendance. Other measures, such as the time a patient waits to see a clinician in A&E, are also now recorded.
For these reasons, we should be cautious about placing too much emphasis on the four-hour standard. The safety and quality of care, as well as patient experience, are as important as how rapidly care is provided. In December 2016, NHS Improvement announced that from 2017 hospitals would be rated against a new scorecard for A&Es that would include the four-hour standard and further metrics on clinical standards and patient and staff experience. The four-hour standard is likely to remain the focus of attention for the public, politicians, regulators and the