A&E departments are in considerable demand and proper utilization of these services can lead to improvement in the quality and promptness of clinical services offered.
However contrary to Chow's arguments, several hospital emergency departments may be directly related to primary care in providing rapid access and an emergency care network could be established in primary care as well. Integrating the strengths and weaknesses of emergency care with objective data model could help in describing multiple levels of operation and in highlighting process efficiency and clinical effectiveness. The support systems within NHS Direct have shown how people do things within A&E departments especially and how deliberate and thoughtful care could be provided by improving network operations. Accident and emergency departments and networking can help measure and control effective networking and promote interactions.
The recent strategic policy shift towards a primary care-led National Health Service in the UK (Department of Health, 1994) has led to renewed interest in redefining the boundaries between primary and secondary care with the aim of shifting selected services traditionally provided in the acute hospital to less resource-intensive primary and community based alternatives.
This systematic literature review looks at the potential for effective service provision for young A & E patients at mixed A & Es in UK. The UK has experienced a rapid increase in general practitioner out of hour's co-operatives over the last 5 years. More generally, a government review of emergency pre-hospital care in England and Wales recently resulted in a series of pilot schemes to test interventions such as computer-driven telephone triage and advice (Department of Health 1997).Such developments are not surprising. Hospital emergency services are under increasing pressure as emergency admissions rise, (Capewell 1996) junior staffing levels are constrained, (Department of Health 1995) and long-term trends in accident and emergency (A & E) attendance remain high. (Hallam 1996) Yet many attenders at A & E departments, perhaps around a quarter, (Lowy 1994) attend with minor injuries or illness not requiring specialist attention. It has long been argued that these patients would be more appropriately treated in primary and community settings. (Dale 1998)
This discussion deals with accident and emergency services provided to children and adults and the differences in A&E services given to different categories of patients. (Padgett 1992) The inclusion of social work within the Accident and Emergency departments or A&Es could help to bring out a social or health policy, especially for older people that would discourage older people from taking unnecessary admissions to acute hospital units on social grounds. However social work with A&E