NHS HOT TOPICS EXAM QUESTIONS WITH
VERIFIED ANSWERS
What is A&E?
Type 1: Major, consultant-led, 24/7 departments (most attendances)
Type 2: Specialist emergency departments
Type 3: Minor injuries/illnesses (walk-in centres, MIUs)
A&E waiting times
4-hour target not met nationally since 2013
Most A&E units in England & Wales miss the target
Causes: staff shortages and financial austerity
Reasons for the Crisis in A&E
Rising attendances: Increasing demand even before COVID-19
Fewer hospital beds: Bed numbers ↓, occupancy rates ↑
Exit block: No ward beds → delays admission & treatment
Ageing population: More complex emergency needs
Unnecessary attendances: GP access issues / lack of awareness
Delayed discharge (bed blocking): Patients fit to leave but lack community care
Staff shortages: Burnout, sickness, resignations increase pressure
Should the 4-Hour Target Be Scrapped?
Useful benchmark but doesn’t reflect case complexity
Safety & quality of care should come first
Other performance measures:
7-day re-attendance rates
Time to see a clinician
CQC ratings
Patient satisfaction
Possible Solutions for A&E crisis:
Urgent Care Hubs: GPs, A&E staff, pharmacists, urgent care teams
,Direct patients to appropriate care
Reduced A&E pressure (e.g. 2017 Cambridgeshire pilot)
Challenges: staffing shortages, rural access issues
Invest in GPs & community pharmacies to reduce A&E demand
Recent A&E statistics
27.4 million A&E attendances in 2024–25
+4% vs 2023–24, +27.4% vs 2011–12
73.9% of patients seen within 4 hours (2024–25)
Legality of abortion in the UK
Legal in England, Wales & Scotland up to 24 weeks
Requires agreement of two doctors
Grounds: risk to woman’s physical or mental health or child’s health
After 24 weeks: legal if:
Woman’s life is at risk
Severe fetal disability
Serious mental/physical harm to the woman
Methods of Abortion
Surgical abortion
- Up to 14 weeks: vacuum/suction aspiration
- After 14 weeks: dilation and evacuation (D&E)
Medical abortion
- Up to 10 weeks
- Mifepristone: blocks progesterone (taken first)
- Misoprostol: causes contractions to expel pregnancy
Abortion at Home
2018: second pill allowed at home
- Seen as safer and more compassionate
- Reduces risk of miscarriage during travel
,Criticism from groups such as SPUC and Right to Life
COVID-19: both pills allowed at home due to lockdown
Abortion in northern Ireland
Abortion legal since October 2019
Up to 12 weeks: unconditional
Up to 24 weeks: risk to woman’s mental/physical health
After 24 weeks: severe fetal impairment
Previously women had to pay or travel for abortions
Ageing population meaning
Meaning
Demographic shift where the proportion of people aged 65+ increases
UK has 3.2 million people aged 80+
Expected to reach ~8 million by 2050
By 2050, 25% of the population will be over 65
Impacts of an Ageing population on Health & Social Care
Increased treatment of chronic conditions:
- Heart disease, type 2 diabetes, arthritis, Alzheimer’s
Older people have complex health and social care needs
Dementia prevalence:
- 1 in 6 people aged 80+
~70% of care home residents have dementia or severe memory loss
High personal care costs:
- People with dementia may spend ~£100,000 on care
Pressure on NHS & Social Care due to ageing population
Cuts to social care → higher A&E admissions among 65+
Inadequate care leads to preventable issues:
Falls, infections, dehydration
Bed blocking:
, - Elderly patients take longer to discharge
- Reduces bed availability → A&E delays & ambulance handover delays
Causes of delayed discharge:
- Shortage of social care staff
- Lack of residential/nursing home beds
- Delays in funding, assessments & home adaptations
Financial Impact due to ageing population
Smaller working population
Increased spending on health and social care services
Comorbidity require more medication and management
Life expectancy
Life expectancy:
-Men 79.9, Women 83.6
HLE:
- Men 63.1, Women 63.6
HLE = years lived in good health
- Gap between life expectancy and HLE is increasing → longer periods of poor health
Government Response to Ageing population
Aim: increase HLE by 5 years by 2035
Strategies:
Public health education (smoking, alcohol, nutrition, exercise)
Reduce risk factors for heart disease & dementia
Better support for disabled people & those with long-term conditions
Invest in public health + social care
Meaning of AI
Ability of computers/machines to perform tasks requiring intelligence
Computers that can make decisions
Process: collect data → interpret → produce output
VERIFIED ANSWERS
What is A&E?
Type 1: Major, consultant-led, 24/7 departments (most attendances)
Type 2: Specialist emergency departments
Type 3: Minor injuries/illnesses (walk-in centres, MIUs)
A&E waiting times
4-hour target not met nationally since 2013
Most A&E units in England & Wales miss the target
Causes: staff shortages and financial austerity
Reasons for the Crisis in A&E
Rising attendances: Increasing demand even before COVID-19
Fewer hospital beds: Bed numbers ↓, occupancy rates ↑
Exit block: No ward beds → delays admission & treatment
Ageing population: More complex emergency needs
Unnecessary attendances: GP access issues / lack of awareness
Delayed discharge (bed blocking): Patients fit to leave but lack community care
Staff shortages: Burnout, sickness, resignations increase pressure
Should the 4-Hour Target Be Scrapped?
Useful benchmark but doesn’t reflect case complexity
Safety & quality of care should come first
Other performance measures:
7-day re-attendance rates
Time to see a clinician
CQC ratings
Patient satisfaction
Possible Solutions for A&E crisis:
Urgent Care Hubs: GPs, A&E staff, pharmacists, urgent care teams
,Direct patients to appropriate care
Reduced A&E pressure (e.g. 2017 Cambridgeshire pilot)
Challenges: staffing shortages, rural access issues
Invest in GPs & community pharmacies to reduce A&E demand
Recent A&E statistics
27.4 million A&E attendances in 2024–25
+4% vs 2023–24, +27.4% vs 2011–12
73.9% of patients seen within 4 hours (2024–25)
Legality of abortion in the UK
Legal in England, Wales & Scotland up to 24 weeks
Requires agreement of two doctors
Grounds: risk to woman’s physical or mental health or child’s health
After 24 weeks: legal if:
Woman’s life is at risk
Severe fetal disability
Serious mental/physical harm to the woman
Methods of Abortion
Surgical abortion
- Up to 14 weeks: vacuum/suction aspiration
- After 14 weeks: dilation and evacuation (D&E)
Medical abortion
- Up to 10 weeks
- Mifepristone: blocks progesterone (taken first)
- Misoprostol: causes contractions to expel pregnancy
Abortion at Home
2018: second pill allowed at home
- Seen as safer and more compassionate
- Reduces risk of miscarriage during travel
,Criticism from groups such as SPUC and Right to Life
COVID-19: both pills allowed at home due to lockdown
Abortion in northern Ireland
Abortion legal since October 2019
Up to 12 weeks: unconditional
Up to 24 weeks: risk to woman’s mental/physical health
After 24 weeks: severe fetal impairment
Previously women had to pay or travel for abortions
Ageing population meaning
Meaning
Demographic shift where the proportion of people aged 65+ increases
UK has 3.2 million people aged 80+
Expected to reach ~8 million by 2050
By 2050, 25% of the population will be over 65
Impacts of an Ageing population on Health & Social Care
Increased treatment of chronic conditions:
- Heart disease, type 2 diabetes, arthritis, Alzheimer’s
Older people have complex health and social care needs
Dementia prevalence:
- 1 in 6 people aged 80+
~70% of care home residents have dementia or severe memory loss
High personal care costs:
- People with dementia may spend ~£100,000 on care
Pressure on NHS & Social Care due to ageing population
Cuts to social care → higher A&E admissions among 65+
Inadequate care leads to preventable issues:
Falls, infections, dehydration
Bed blocking:
, - Elderly patients take longer to discharge
- Reduces bed availability → A&E delays & ambulance handover delays
Causes of delayed discharge:
- Shortage of social care staff
- Lack of residential/nursing home beds
- Delays in funding, assessments & home adaptations
Financial Impact due to ageing population
Smaller working population
Increased spending on health and social care services
Comorbidity require more medication and management
Life expectancy
Life expectancy:
-Men 79.9, Women 83.6
HLE:
- Men 63.1, Women 63.6
HLE = years lived in good health
- Gap between life expectancy and HLE is increasing → longer periods of poor health
Government Response to Ageing population
Aim: increase HLE by 5 years by 2035
Strategies:
Public health education (smoking, alcohol, nutrition, exercise)
Reduce risk factors for heart disease & dementia
Better support for disabled people & those with long-term conditions
Invest in public health + social care
Meaning of AI
Ability of computers/machines to perform tasks requiring intelligence
Computers that can make decisions
Process: collect data → interpret → produce output
