Hospitals may not close their emergency rooms if it causes more people to take longer than 45 minutes to reach an emergency room. But this legal standard is dated, according to the Dutch Healthcare Authority (NZa). Partly for this reason, the number of places for emergency care (seh) must be reviewed.
The NZa advises this in a report published this week. In it, the health care authority writes that the Ministry of Health must come up with a new national framework for the distribution of acute care based on medical-scientific substantiation.
The NZa believes that money and hospital staff can be deployed more efficiently. Due to a shortage of staff, it is necessary to reconsider per region which places for emergency care can close. Only closing the emergency aid at night is also an option.
Ambulances much better than 20 years ago
The NZa critically examines the so-called 45-minute standard. This would preclude effective care because it is based on historical distribution of healthcare providers. This means that emergency rooms remain open where few ambulances arrive.
Moreover, according to the health care authority, ambulances are much better equipped compared to 2002, the year in which the standard was introduced. ‘Patients can be helped better on the spot and in the ambulance than in the past. The driving time to an emergency room has therefore become less relevant (for certain care questions),’ according to the NZa in the advisory report.
A different regional distribution of emergency care is seen by the NZa as an opportunity to meet the personnel, qualitative and financial challenges. Concentrating the number of patients presenting at ‘quiet’ A&Es per night may be a solution to the labor market problem in some regions, because fewer healthcare personnel may then need to be available.
Wilhelmina Hospital and Treant Care Group
Whether concentration is necessary differs per region, the NZa emphasizes. In any case, the care authority does not seem to be referring to the catchment area of Treant Zorggroep. In Hoogeveen and Stadskanaal, the emergency departments were already among the smallest in the country, with approximately 9,000 patients per year. The emergency rooms have since been converted into basic emergency posts that are open during the day and in the evening. ‘Thanks to this reorganization, Treant Zorggroep in Emmen can offer acute care with sufficient and well-qualified staff,’ the NZa writes. Because Treant is cited in the report as a ‘practical case’, Treant is not afraid of closing the emergency room in Emmen.
What the report means for emergency care in Drenthe remains unclear for the time being, because the Ministry of Health has yet to decide. The Wilhelmina Hospital in Assen states that the availability of care is central, close to the patient.