A&E App

Matt Hancock, the Heath Secretary is proud of the NHS’s latest app. It is designed to help patients find the accident and emergency department with the shortest waiting time. He claims that the app will be’ good for patients, good for clinicians’.

It won’t work for two reasons, firstly it is tackling the wrong problem and secondly it may make things worse.

Anyone who has ever waited in A&E knows how frustrating it can be. Your heart sinks when you see the board on the wall giving the length of the wait to be seen. The truth is, however, that patients will be seen on a needs basis. Those who have life threatening injuries or conditions will get to the front of the queue while those who are able to wait will be made to do so, depending upon medical resource available.

A&E is not like going to a supermarket. Waiting times is a very crude way of judging a hospital’s performance. The effectiveness of treatment is much more valid yet this is harder to measure as it may take weeks for the patient to recover fully.

Being able to choose which hospital to go to assumes a number of things: you have a realistic choice of more than hospital; you are able to get there using public transport or have a car, you have access to technology; you are in a fit state to use it in an emergency.

If you are really in trouble then the last thing you will want to do is to make a choice on waiting time. You will want to make a choice of how quickly you can get there.

This is why the app may make things worse. Those who are in a position to decide which hospital to choose are more likely to be those with time to think about the issue, that is those that are not in a life threatening situation and, by its very nature, should not be going to A&E anyway but rather their GP surgery. If I am not feeling well but not in an emergency and I see that the local A&E has a fairly short waiting time then I am more likely to be tempted to make a visit.

RAther than encouraging people to move demand around the system it will create new demand from patients that should not really be there.

The app is solutionism at its worst. It give the impression of doing something but actually inflames the problem.