What is happening in urgent care?

The capacity problems in A&E are now widely recognised, with shortages in A&E staffing, ready access to a GP or even the ageing population widely blamed (Jones, 2013c–h). However, Figures 1 and 2 reveal the consequences of an event in early 2012, which also led to increased deaths and medical admissions (Jones, 2013a–e), and marks the point of a sudden and unexpected shift in the case mix arriving at A&E. On the x-axis of Figure 1 are a series of more serious medical conditions (highly likely to require ambulance transport and result in an admission), which substantially increased their share of the arriving case mix with associated reductions in the proportion of less serious ambulatory and minor injury type conditions. Hence, there was a step-like increase in admissions to A&E seen to occur around February of 2012 (Jones, 2013b), and the abrupt nature of this shift is illustrated in Figure 2, where continuous trends prior to 2012/13 are suddenly interrupted.