Imperial College London
Alternate

Emeritus ProfessorDerekBell

Faculty of Medicine, School of Public Health

Emeritus Professor in Acute Medicine
 
 
 
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Contact

 

+44 (0)7886 725 212d.bell

 
 
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Assistant

 

Miss Heather Barnes +44 (0)20 3315 8144

 
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Location

 

Chelsea and Westminster HospitalChelsea and Westminster Campus

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Summary

 

Publications

Citation

BibTex format

@article{Kremers:2019:10.1186/s12873-019-0257-y,
author = {Kremers, MNT and Nanayakkara, PWB and Levi, M and Bell, D and Haak, HR},
doi = {10.1186/s12873-019-0257-y},
journal = {BMC Emergency Medicine},
pages = {1--7},
title = {Strengths and weaknesses of the acute care systems in the United Kingdom and the Netherlands: what can we learn from each other?},
url = {http://dx.doi.org/10.1186/s12873-019-0257-y},
volume = {19},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundThe demand on Emergency Departments and acute medical services is increasing internationally, creating pressure on health systems and negatively influencing the quality of delivered care. Visible consequences of the increased demand on acute services is crowding and queuing. This manifests as delays in the Emergency Departments, adverse clinical outcomes and poor patient experience.OverviewDespite the similarities in the UK’s and Dutch health care systems, such as universal health coverage, there are differences in the number of patients presenting at the Emergency Departments and the burden of crowding between these countries. Given the similarities in funding, this paper explores the similarities and differences in the organisational structure of acute care in the UK and the Netherlands. In the Netherlands, less patients are seen at the ED than in England and the admission rate is higher. GPs and so-called GP-posts serve 24/7 as gatekeepers in acute care, but EDs are heterogeneously organised. In the UK, the acute care system has a number of different access points and the accessibility of GPs seems to be suboptimal. Acute ambulatory care may relieve the pressure from EDs and Acute Medical Units. In both countries the ageing population leads to a changing case mix at the ED with an increased amount of multimorbid patients with polypharmacy, requiring generalistic and multidisciplinary care.ConclusionThe acute and emergency care in the Netherlands and the UK face similar challenges. We believe that each system has strengths that the other can learn from. The Netherlands may benefit from an acute ambulatory care system and the UK by optimizing the accessibility of GPs 24/7 and improving signposting for urgent care services. In both countries the changing case mix at the ED needs doctors who are superspecialists instead of subspecialists. Finally, to improve the organisation of health care, doctors need to be visible medical leaders and participate in
AU  - Kremers,MNT
AU  - Nanayakkara,PWB
AU  - Levi,M
AU  - Bell,D
AU  - Haak,HR
DO  - 10.1186/s12873-019-0257-y
EP  - 7
PY  - 2019///
SN  - 1471-227X
SP  - 1
TI  - Strengths and weaknesses of the acute care systems in the United Kingdom and the Netherlands: what can we learn from each other?
T2  - BMC Emergency Medicine
UR  - http://dx.doi.org/10.1186/s12873-019-0257-y
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000477654900001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://bmcemergmed.biomedcentral.com/articles/10.1186/s12873-019-0257-y#article-info
UR  - http://hdl.handle.net/10044/1/96187
VL  - 19
ER  -
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