There were about 12.7 million visits to accident and emergency (AandE) services in the last year, and in around a fifth of these, patients were admitted to hospital. AandE departments are only one in a variety of NHS emergency care providers, which include ambulance services, GPs, primary care trusts, out-of-hours services; NHS Direct; and open access minor injury centres. This NAO report examines the extent of progress made towards achieving the key target for maximum total time spent waiting for AandE services, as well as with the wider modernisation of emergency care. The report's conclusions include that, given the high level of demand, there has been a significant and sustained progress towards reducing waiting times in AandE departments and improving the patient's experience, largely due to improved working practices and increased local investment. However, there is further room for improvement in the case of patients with more complex needs, such as older people and those with mental health needs; and regional variations still exist with the performance of the worst performing trusts still some way behind. Further major improvements will depend on tackling the remaining bottlenecks and barriers to modernisation within wider emergency care services. The establishment of local emergency care networks is highlighted as a promising development, as a means to secure greater emergency care service integration and joint-working.

Today our emergency care system faces an epidemic of crowded emergency departments, patients boarding in hallways waiting to be admitted, and daily ambulance diversions. Hospital-Based Emergency Care addresses the difficulty of balancing the roles of hospital-based emergency and trauma care, not simply urgent and lifesaving care, but also safety net care for uninsured patients, public health surveillance, disaster preparation, and adjunct care in the face of increasing patient volume and limited resources. This new book considers the multiple aspects to the emergency care system in the United States by exploring its strengths, limitations, and future challenges. The wide range of issues covered includes: • The role and impact of the emergency department within the larger hospital and health care system. • Patient flow and information technology. • Workforce issues across multiple disciplines. • Patient safety and the quality and efficiency of emergency care services. • Basic, clinical, and health services research relevant to emergency care. • Special challenges of emergency care in rural settings. Hospital-Based Emergency Care is one of three books in the Future of Emergency Care series. This book will be of particular interest to emergency care providers, professional organizations, and policy makers looking to address the deficiencies in emergency care systems.

Following on from an NAO report (HCP 1075, session 2003-04; ISBN 010293021X) published in October 2004, the Committee's report examines the level of demand for emergency care within the NHS, the progress made towards achieving waiting time targets for emergency care services and service integration. Findings reached include that the proportion of patients being discharged or admitted from A&E services in under four hours has risen from 77 per cent in September 2002 to 94.6 per cent in September 2004, although treatment times are still too long for many patients, particularly older or vulnerable patients. As demand for emergency care continues to rise, emergency care networks should be given responsibility for reviewing local patterns of demand compared to supply and commission services accordingly. The expanded levels of access to services through the establishment of new providers is to be welcomed, although more research needs to be done on assess the relative unit costs of these services.

Based on careful analysis of burden of disease and the costs ofinterventions, this second edition of 'Disease Control Priorities in Developing Countries, 2nd edition' highlights achievable priorities; measures progresstoward providing efficient, equitable care; promotes cost-effectiveinterventions to targeted populations; and encourages integrated effortsto optimize health. Nearly 500 experts - scientists, epidemiologists, health economists,academicians, and public health practitioners - from around the worldcontributed to the data sources and methodologies, and identifiedchallenges and priorities, resulting in this integrated, comprehensivereference volume on the state of health in developing countries.

There were about 12.7 million visits to accident and emergency (A&E) services in the last year, and in around a fifth of these, patients were admitted to hospital. A&E departments are only one in a variety of NHS emergency care providers, which include ambulance services, GPs, primary care trusts, out-of-hours services; NHS Direct; and open access minor injury centres. This NAO report examines the extent of progress made towards achieving the key target for maximum total time spent waiting for A&E services, as well as with the wider modernisation of emergency care. The report's conclusions include that, given the high level of demand, there has been a significant and sustained progress towards reducing waiting times in A&E departments and improving the patient's experience, largely due to improved working practices and increased local investment. However, there is further room for improvement in the case of patients with more complex needs, such as older people and those with mental health needs; and regional variations still exist with the performance of the worst performing trusts still some way behind. Further major improvements will depend on tackling the remaining bottlenecks and barriers to modernisation within wider emergency care services. The establishment of local emergency care networks is highlighted as a promising development, as a means to secure greater emergency care service integration and joint-working.