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Urgent care and the patient
  1. C Salisbury1,
  2. A Coulter2
  1. 1University of Bristol, Bristol, UK
  2. 2Coulter & Coulter Ltd, Bitterwell house, Eynsham, Oxfordshire OX29 4JL, UK
  1. Correspondence to Professor Chris Salisbury, University of Bristol, 25 Belgrave Road, Bristol BS8 2AA, UK; c.salisbury{at}

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The first principle of the government's “Reforming Emergency Care” strategy1 2 is that services should be designed from the point of view of the patient. However, this aspiration does not always seem to be fulfilled. We can learn how to improve the urgent care system by listening and acting on patients' views.

Why do patients' views matter?

Urgent care has been defined as “the range of responses that health and care services provide to people who require—or who perceive the need for—urgent advice, care, treatment or diagnosis.”3 This patient-centred definition avoids a description of specific services and instead places responsibility on all service providers to act promptly in response to requests for urgent help. They are required to respect patients' perceptions of urgency and respond with careful assessments of their patients' care needs. Instead of focusing effort on reducing “inappropriate” use of urgent care services, it is more helpful to understand why people present for urgent advice and adapt the services to meet the needs identified. Approaching service redesign through the patients' eyes by seeking regular feedback on their experiences is the best way to ensure that appropriate advice and help are available wherever and whenever they are needed. This is also likely to be cost-effective, since services that do not match patients' needs tend to be badly used.

International patient surveys show wide variations in patients' reported experiences of access to urgent care. Same-day appointments and easy access to out-of-hours care are the norm in Germany and New Zealand, but patients in …

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  • Competing interests The Picker Institute gains part of its income from measuring patients' experience and using the results to improve healthcare quality. AC is a member of the BMJ's advisory board.

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  • Provenance and peer review Commissioned; not externally peer reviewed.

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