One of the top doctors of England revealed that the NHS should have a two-tier A&E system. The system should also consist of a part which involves telephone discussion with GPs and nurse to take the stress off casualty wards that are `creaking at the seams'.

Sir Bruce Keogh, NHS England's Medical Director, said patients suffering from slight conditions should be taken care in homes as much as possible. However, treatment for most severe medical emergencies should be treated at major emergency centers.

As per the report, GPs, local pharmacists, paramedics and the NHS 111 telephone triage service should put their efforts so as keep people out of hospital whereas A&E divisions should be reanalyzed.

From 40 to 70 A&E units with the majority specialist apparatuses and proficiency will call around 5% of patients suffering from the most serious conditions such as heart attacks and strokes. Another 70 to 100 will be called as `emergency centers' to treat severe conditions that may not require specialist intervention. He said the improvements were "the only way to create a sustainable solution" to the problem.

With the improvement in field of medical science and advancement in technology, nay changes have occurred in the society. People now live a longer life which brings many health problems and also prospect of the public have changed.