BACKGROUND The demand on Emergency Departments and acute medical services is increasing internationally, creating pressure on health systems and negatively influencing the quality of delivered care. Visible consequences of the increased demand on acute services is crowding and queuing. This manifests as delays in the Emergency Departments, adverse clinical outcomes and poor patient experience. OVERVIEW Despite the similarities in the UK's and Dutch health care systems, such as universal health coverage, there are differences in the number of patients presenting at the Emergency Departments and the burden of crowding between these countries. Given the similarities in funding, this paper explores the similarities and differences in the organisational structure of acute care in the UK and the Netherlands. In the Netherlands, less patients are seen at the ED than in England and the admission rate is higher. GPs and so-called GP-posts serve 24/7 as gatekeepers in acute care, but EDs are heterogeneously organised. In the UK, the acute care system has a number of different access points and the accessibility of GPs seems to be suboptimal. Acute ambulatory care may relieve the pressure from EDs and Acute Medical Units. In both countries the ageing population leads to a changing case mix at the ED with an increased amount of multimorbid patients with polypharmacy, requiring generalistic and multidisciplinary care. CONCLUSION The acute and emergency care in the Netherlands and the UK face similar challenges. We believe that each system has strengths that the other can learn from. The Netherlands may benefit from an acute ambulatory care system and the UK by optimizing the accessibility of GPs 24/7 and improving signposting for urgent care services. In both countries the changing case mix at the ED needs doctors who are superspecialists instead of subspecialists. Finally, to improve the organisation of health care, doctors need to be visible medical leaders and participate in the organisation of care.

中文翻译：

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英国和荷兰的急诊系统的优缺点：我们可以从中学到什么？

背景技术国际上对急诊科和急诊服务的需求正在增加，这给卫生系统造成了压力，并对所提供的护理质量产生了负面影响。对急救服务需求增加的明显后果是拥挤和排队。这表现为急诊科的延误，不良的临床结果和不良的患者经验。概述尽管英国和荷兰的医疗保健系统存在相似之处，例如全民医疗保险，但急诊科的病人人数以及这些国家之间的拥挤负担仍存在差异。考虑到资金的相似性，本文探讨了英国和荷兰急诊医疗组织结构的异同。在荷兰，急诊就诊的患者少于英格兰，住院率更高。全科医生和所谓的全科医生岗位在紧急护理中充当24/7的看门人，但急诊室的组织却很不统一。在英国，急症护理系统有许多不同的接入点，而全科医生的可及性似乎不是最理想的。急性非卧床护理可减轻急诊室和急性医疗部门的压力。在这两个国家中，人口老龄化导致急诊室的病例组合发生变化，多药合用的多病态患者数量增加，需要综合和多学科的护理。结论荷兰和英国的急诊和急诊护理面临类似的挑战。我们相信，每个系统都有其他可以借鉴的优势。通过优化24/7号全科医生的可及性并改善紧急护理服务的路标，荷兰可以从急性门诊护理系统中受益，而英国则可以从中受益。在这两个国家，急诊室不断变化的病例组合都需要超级专科医生而不是专科医生的医生。最后，为了改善医疗保健的组织，医生需要成为可见的医疗领导者并参与医疗保健的组织。