Care Pathways

02.03.18

Scale of emergency admissions poses ‘serious challenge’ to NHS services and finances

A worrying National Audit Office (NAO) report has revealed that rising numbers of emergency hospital admissions are posing ‘serious challenges’ to NHS services.

Emergency admissions cost the service £13.7bn in 2015-16 and there has been a 2% increase in the number of these cases in 2016-17.

While the report gives NHS staff credit for their efforts to reduce the number of these kinds of admissions, it questions whether efforts to quickly deal with emergency situations could be causing a surge in readmissions.

In addition, the NAO highlighted fears that around a quarter of the 5.8 million A&E admissions in 2016-17 were considered avoidable by NHS England.

The study gives a number of recommendations on the issue, mainly aimed at understanding the link between the emergency process and higher readmissions.

“The department, NHS England and NHS Improvement should establish an evidence base for what works in reducing emergency admissions and use this to inform future national programmes,” it suggests.

“The department, NHS England and NHS Improvement have not yet established a robust evidence base to show what works in reducing demand for emergency admissions.

“Many admission reduction interventions have not been tested at scale, and the department, NHS England and NHS Improvement are unable to show whether any success is both sustainable and attributable to those interventions.”

Increases in emergency admissions have been partly blamed on an ageing population, which the NAO believes could be responsible for as much as £3.4bn of NHS funds.

Providers: Lack of capacity has knock-on effect on admission trends

The report has received mixed reactions from the health sector, with NHS Providers welcoming the acknowledgement that the NHS as a whole is working hard to reduce admissions, but pointing to a lack of capacity in communities, which could be responsible for more patients returning to hospitals.

“The NAO is right to point to the health service’s success in managing the impact of increased emergency admissions on hospitals,” commented deputy chief executive Saffron Cordery.

“The NAO report shows that although admissions have increased, trusts have been cost-effective at managing the additional demand, and have coped well despite the number of beds reducing by around 6% between 2010 and 2017. On top of this, trusts have had to cope with reduced tariff payments for admissions.

“We agree there is a need for better data to understand properly the rise in re-admissions and avoidable admissions, and the drivers behind the increase in short stay admissions.

“But what is clear, as the NAO rightly points out, is a lack of capacity out of hospital care to deal with growing demand for treatment, has had a knock-on impact on trends in admission.”

The link between community and hospital care has prompted the Local Government Association (LGA) to ask for further funding for the social care system.

“Councils are working closely with the NHS to avoid unnecessary admissions to hospital through better self-management of conditions, better community support and better advice and information,” explained Cllr Linda Thomas, vice chair of the LGA’s Community Wellbeing Board.

“However, due to historic underfunding, the adult social care system is under significant pressure and community-based services are being reduced, which is impacting on inpatient services. This reduced government funding means councils have had to spend less on key prevention work – £64m less in the past year.

“The LGA has consistently argued that there needs to be a focus on preventing hospital admissions in the first place rather than focusing disproportionately on delayed discharges of care.”

Have you got a story to tell? Would you like to become an NHE columnist? If so, click here  

Comments

There are no comments. Why not be the first?

Add your comment

 

national health executive tv

more videos >

latest healthcare news

Highest ever numbers accept GP training posts

19/10/2018Highest ever numbers accept GP training posts

The number of people entering GP training is the highest in NHS history, according to new figures from Health Education England (HEE). A tot... more >
‘No realistic prospect of progress’ for integrated health and social care, PAC warns

19/10/2018‘No realistic prospect of progress’ for integrated health and social care, PAC warns

The government is still “a long way” from achieving an effective strategy for integrated health and social care and has been urged to... more >
One in six trusts could end PFI contracts due to poor performance as NHS heads for £1bn loss

19/10/2018One in six trusts could end PFI contracts due to poor performance as NHS heads for £1bn loss

A new report has revealed that 15% of all NHS trusts using private finance initiatives (PFI) could terminate contracts due to poor performance. ... more >

editor's comment

25/09/2017A hotbed of innovation

This edition of NHE comes hot on the heels of this year’s NHS Expo which, once again, proved to be a huge success at Manchester Central. A number of announcements were made during the event, with the health secretary naming the second wave of NHS digital pioneers, or ‘fast followers’, which follow the initial global digital e... read more >

last word

Hard to be optimistic

Hard to be optimistic

Rachel Power, chief executive of the Patients Association, warns that we must be realistic about the very real effects of continued underfunding across the health service. It’s now bey... more > more last word articles >

the scalpel's daily blog

On your bike!

17/10/2018On your bike!

Sathish Sethuraman, travel and transport plan co-ordinator at Northumbria Healthcare NHS FT, explains how efforts to promote cycling to work at the trust are resulting in more staff travelling on two wheels. At Northumbria Healthcare, we are committed to becoming a greener organisation and reducing the environmental impact of delivering p... more >
read more blog posts from 'the scalpel' >

comment

Recoup and recover

10/10/2018Recoup and recover

The ease and round-the-clock nature of making cashless payments has transformed the way we pay for goods and services – and, from now on, t... more >
The clinical voice at the heart of procurement

10/10/2018The clinical voice at the heart of procurement

Jo Gander, director of the Clinical and Product Assurance (CaPA) team, talks about their role as part of the new NHS Supply Chain. NHS Suppl... more >
Deal or no deal?

10/10/2018Deal or no deal?

Dr Andrew Dearden, BMA treasurer and Brexit lead, takes a look at what different Brexit scenarios could means for both patients and healthcare pr... more >
A push for digital in mental health

10/10/2018A push for digital in mental health

Sean Duggan, chief executive of NHS Confederation’s Mental Health Network, argues that mental health services could hugely benefit from dig... more >

interviews

Duncan Selbie: A step on the journey to population health

24/01/2018Duncan Selbie: A step on the journey to population health

The NHS plays a part in the country’s wellness – but it’s far from being all that matters. Duncan Selbie, chief executive of Pu... more >
Cutting through the fake news

22/11/2017Cutting through the fake news

In an era of so-called ‘fake news’ growing alongside a renewed focus on reducing stigma around mental health, Paul Farmer, chief exec... more >
Tackling infection prevention locally

04/10/2017Tackling infection prevention locally

Dr Emma Burnett, a lecturer and researcher in infection prevention at the University of Dundee’s School of Nursing and Midwifery and a boar... more >
Scan4Safety: benefits across the whole supply chain

02/10/2017Scan4Safety: benefits across the whole supply chain

NHE interviews Gillian Fox, head of eProcurement (Scan4Safety) programme at NHS Supply Chain. How has the Scan4Safety initiative evolved sin... more >

health service focus

View all News