A&E in NI: a problem of emergent use versus public service development

I have always been fascinated by emergent development. This is the unintended design from actual use rather than the laid down design by architects or town planners.

We see this in everyday life in the development of “cow paths”.

An architect or town planner says you should walk this way? And the public use a slightly different route and that’s because the people know best. They aren’t wilfully destroying carefully coiffeured grass ways, they’re trying to get somewhere. Planners and architects need to think about this.

The same goes for public services. This is an article from BelfastLive.

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Just under half the people who turned up at Northern Ireland’s A&Es last year were not emergency cases, shock figures have revealed.

Statistics provided by the Department of Health, Social Services and Public Safety (DHSSPS) also show only 14% of patients arriving at casualty units had suffered major trauma and needed immediate care.

And yet we hear nightmare stories of people being kept on trollies for hours or how our emergency medical services are completely overburdened. It’s obvious the problem is one of design, not one of staffing.

In light of this, we should be re-designing our public services to meet what the public plainly want. They want to get seen by a medical professional.

I’ve previously proposed that a better solution might be to put a paramedic station in every town, maybe built onto the side of a health centre or GP practice. Somewhere where local people can flock and always be seen in an emergency. The current system of A&E and Out of Hours GP plainly isn’t working so we have to start to think smarter. If every large business tends to have a first-aider on every floor, why doesn’t every town have an emergency station?

The naming of the place is important too. What may be a sprain to you or me, is a break in the mind of someone who is hurt. It has to be described as the place you go when you have a medical emergency and the definition of emergency is entirely subjective.

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