While a.wider choice of services is a good thing.for patient care, the public needs more guidance on where to go for non-emergency urgent care, says David Baker.

During a recent holiday in Cornwall, I found myself in the depths of the Lizard peninsula, almost at the cottage we had rented. I say almost as the map suggested we should have arrived, yet we appeared to be trapped in a web of country lanes that led to somewhere other than our destination. Each weather-worn sign directed us to another, which in turn led us back to our starting point. While we reached the cottage in time for our pasties, it wasn't without an uncomfortable half hour of bewilderment and family frictions.

Returning to work a fortnight later, I was reminded of my frustrations during a discussion about the choices presented to patients needing urgent care. Geography no longer dictates patients' access to health advice and support in urgent care situations - on offer are.GPs, accident and emergency, the NHS Direct helpline and website, walk-in centres, urgent care centres, out-of-hours services - the list goes on.

The idea that a wider choice of services is a positive thing for patient care is logical, but.the public needs more guidance on where to go for non-emergency urgent care..

Imagine this scenario: a patient living in the centre of a city falls and injures their wrist. While this isn't life-threatening enough to demand an ambulance, it is causing a great deal of discomfort and needs to be looked at. But where should they go? What factors determine which treatment centre is best for patient care? Which is the most effective means of treating the patient using the most appropriate NHS resources at minimum cost? The patient may be in walking distance of an accident and emergency department.but the injury could be one that is.treatable more quickly (and more cost-effectively) at their local walk-in centre.

The patient is not at fault for selecting an inappropriate service, nor is A&E to blame for treating the patient with the resources available..The job has been done - but it could be done better.The challenge is how to get the most appropriate care for the patient, with the least impact on NHS resources and budgets.

Underlying this argument is the need to assess the value of services such as walk-in centres, in terms of patient care and relieving pressure from A&E departments and GP surgeries. With patients choosing the right route for care in their area, the ability to establish where patients are using new or alternative services is improved..

What is needed is a clear roadmap from the Department of Health, informing patients of where to receive the right level of care, at the right location, in the quickest possible time..At present, this is not the case. Services like NHS Direct could do.so much to guide patients, but are they being used effectively? Could they be doing more to direct patients who are unsure of where to turn?

In the same vein, healthcare services need to know what their role is both to patients and within the wider NHS; staff need to feel valued and budgets need to be justified..

Just as with family holidays, when en route to an uncertain destination, time and money is wasted. While clearer signposting, consistent messages and guided choices are an obvious means of resolving the issue, they are not yet visible.

David Baker is CEO of Clinical Solutions.