It’s baffling that after 14 years, Labour came into government with absolutely no plan for social care.
If anything, their hostility towards immigrants will exacerbate the situation.
We need to get people out of acute hospital beds who don’t need to be there. It’s not a new problem.

maybe a radical solution would be to accept that if members of the public *do* vote with their feet and go to a place where the lights are on 365/24 we create sufficient capacity (though maybe right not always in the major A&E dept estate) to meet that self defined "need"

I think there *is* an issue around societal attitudes to (often short lived) illness or minor injury, tolerance of risk compared to a few years back where people lack the confidence or patience to self-manage, watch and wait and want quick answers and quick solutions (as do their employers)

as Steve says, this is absolutely *not* the cause
the cause is patients who are sick enough to need admission to a bed either on acute medical unit or a deeper ward in the hospital for whom there are no beds available because of flow and capacity issues

the main cause of long waits and overcrowding is the number of sick people who do need admission to hospital but for whom beds are not available

Not people with minor illness and injury who can walk in or self refer

"analysis of NHS data by the PA Media news agency". Journalists reporting other journalists, when there's already proper research that shows the true reason.

a lay person or even a trained telephone call handler is not going to know whether the central chest pain is a heart attack or reflux

or whether the sudden onset of dizziness is ear-related or a stroke

or the faint/near faint is a self-limiting one off vasovagal episode or an arrythmia

it is also a total misunderstanding of medical practice in assessing early presentations of undifferentiated patients that because the person ultimately left the department with no new treatment, their self-identified (or 111 identified) need for care was absent

Medicine does not work like that

And research showed that many patients attending for minor illness/injury were perfectly well aware of alternative care destinations but chose A&E despite this and despite risk of long waits

And many were directed there by 111 numbers

well they have spun it slightly differently by making it less about AI algorithms and more about minor illness and injury

but absolutely it is a non story that tells us nothing about the real causes of the crises in primary/community care or A&E departments and seeks to blame patients and GPs

I helped a friend through A+E recently and it's very hard to escape the conclusion that there's just not enough resources in the system. Triage does the best it can be expected to at prioritisation.

Look at that flag. Makes you proud to be British

Getting more people home to die will, you've guessed it, become increasingly expensive with diminishing returns. It is all a matter of choices. Politicians and their NHS administrative servants prioritise cost over experience and outcome.

Hospitals need big investments too, to make them more suitable for frailty, dementia and end of life care. Yes we want to increase deaths at home, but it is neither always possible or desirable. And we may be close to an irreducible minimum (40% of deaths are in hospital).

Remember Derek Wanless? That is what we need. The three shifts are sensible - Wanless urged investment in prevention. But we already do a lot of prevention, any more will yield fewer returns and gets increasingly expensive.

We need to face up to the fact that the whole health service is very substantially underfunded. My guess is by 25-50%

Maternity care works on fine margins. To get ever better outcomes needs disproportionate investment. As a geriatrician, maternity services always appear privileged to me. Top down management by diktat - David Nicholsons 'grip' - and prioritisation of reputation made things worse in Nottingham

-The population is unbalanced, too few young too many old. We need workers and a tax base
-We lack sufficient professional skills
-Intellectual exchange cultural drives a knowledge economy
-We must do our part for the victims of persecution, war and disaster