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Over half a million trips to A&E could be avoided with better management of long-term conditions


By Beth Gault
Freelance journalist
28 August 2018

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Almost 700,000 A&E attendances could be avoided if patients were better supported to manage their long-term conditions, new research has suggested.

A report, published by charity the Health Foundation in the BMJ Quality and Safety journal, found that patients who felt most confident and able to manage their conditions had 38% fewer emergency admissions, 32% fewer A&E attendances and 18% fewer general practice appointments than those who felt least able.

It suggested that 690,000 A&E attendances and 436,000 emergency hospital admissions could be prevented every year if greater priority was given to supporting patients to manage their conditions. This could be achieved by health coaching, peer support and greater access to apps that help people manage symptoms of, for example diabetes, the report said.

The study, which looked at 9,000 adults with long-term conditions, also found that those who felt most able to manage their mental health conditions – as well as physical health conditions – had 49% fewer emergency admissions than patients who felt least able.

The Health Foundation stressed that NHS England ‘must take action now’ to support people to better manage long-term conditions, including prioritising this in the long-term plan for the NHS.

The research called on policymakers to focus on ‘understanding the self-management capability of patients, and the design of interventions which support this’ to help reduce demand on services and ‘reduce inefficient usage’.

Sarah Deeny, assistant director of data analytics at the Health Foundation, said: ‘Patients with long-term conditions manage the majority of their care, spending less than one per cent of their time in contact with a health professional.

‘Supporting these patients to develop the necessary skills, knowledge and confidence to manage their health as effectively as possible is critical to helping them stay well and could help reduce the need for vast number of emergency admissions, A&E attendances and GP appointments.’

‘To ease pressure on services and improve patients’ quality of life, national policy makers and the local NHS must take action now to support people to better manage their long-term conditions. This should include NHS England prioritising support for self-management in the long-term plan for the NHS.’

A&E departments in the UK have been under pressure this year, after recording the second-worst month on record in January after treating or discharging 85.3% of patients within four hours. The NHS aim to see 95% of people in that target time.

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