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Factors contributing to high emergency admissions revealed

Factors contributing to high emergency admissions revealed


Researchers led by the University of Bristol have released a report that indicates a number of factors involved admissions and attendances at emergency departments.

The study Primary care factors and unscheduled secondary care: a series of systematic reviews was compiled by academics from the University’s Centre for Academic Primary Care and revealed that enabling patients to see the same GP every time they attended the surgery can reduce emergency admissions.

Other influences that affected emergency care attendances were:

- Patients’ access to their GP surgeries.

- The distance people live from the emergency department.

- The number of confusing options they had for urgent care.

Research fellow at the University of Bristol, Dr Alyson Huntley the huge costs incurred by NHS for people visiting emergency hospital services and the potential savings that could be made by investing in primary care.

She said: “A recent report by the King’s Fund suggested that admissions among people with long-term conditions that could have been managed in primary care cost the NHS £1.42 billion per year. This could be reduced by up to 18% through investment in primary and community-based services.

“Our work has shown that providing continuity of care and making it easier for patients to get access to their GP can help achieve this reduction in unplanned admissions and emergency department attendance.”

The research recommends that those in high-risk groups, there should be a targeted increase in continuity for GP care.

Those groups include older patients, people from poorer backgrounds and those suffering from multiple conditions.

Research lead, Dr Sarah Purdy said: “GP practices serving the most deprived populations have emergency admission rates that are around 60% higher than those serving the least deprived populations. Our research has highlighted key issues that commissioners of primary care in the UK can tackle in order to bring down unscheduled secondary care use.”

The National Institute for Health Research School for Primary School (NIHR SPCR) funded the study, which was the most comprehensive of its kind.

It analysed 44 different studies from developing countries across the world in order to identify what aspects of primary care affected over-use of secondary care services.

National clinical director for urgent care for NHS England, Professor Jonathan Benger said: “There is a well-recognised need to improve urgent care in England. This report will help to inform both commissioners and providers of care regarding the relationship between general practice, accident and emergency department attendance and emergency hospital admission. The report's findings are reflected in the changes proposed by the ongoing review of urgent and emergency care, led by NHS England's medical director Professor Sir Bruce Keogh.”

Published in the British Medical Journal (BMJ) Open, the work was carried out in conjunction with the Universities of Manchester, Oxford and UCL.



I am a retired NHS physiotherapist, prior to working in one of the first Community Trusts in England. I was trained to reduce acute admissions through various teams in the community, including Rapid Response which, though working brilliantly, was dismantled as mergers took place to save money. The same went for a local integrated health and social care team. Staff satisfaction plummeted and eventually the Community Trust pulled out of bidding for Communty Services. Two private bidders and one large NHS combined trust bidder remain. It is so sad to see this and I blame macro-management, unwise cost cutting and not listening to frontline staff. Backed by experience, I believe Allied Health Professionals hold the key to future health and social well-being.

I am now on the receiving end of care with multiple Long Term Conditions which inter-relate. I want to avoid admission at all costs but do not have time given to me to explain my symptoms, ( some of which need researching) and discuss management of them. Now I have been given permission to carry information on me to warn A&E of their complexity. I have written my medical history for my GP and have a medic alert bracelet and now feel much more in control of my health care.

Perhaps patients should be helped to write such a story rather than undergoing a rigid clinical assessment. It can be proactive and would give them both a sense of satisfaction at writing down how they feel as well as being available for health professionals who undertake their care, often unplanned. In my experience most people love telling their story. Not many have time to listen.

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