Integrated Care & Social Care

08.06.18

Rage as hospitals had to endure 1.5 million ‘avoidable’ emergency admissions in last year

A shocking one in four patients could have avoided emergency admissions in 2016-17 if the health community had worked more effectively, MPs have said.

Emergency admissions — deemed as “unpredictable and at short notice because of clinical need” — showed soaring numbers, with 5.8 million cases in 2016-17 which is up by 2.1% on the previous year.

A report by the Public Accounts Committee (PAC) said it was “lamentable” that one and a half million people could have avoided emergency admissions had hospitals, GPs, community services and social care had worked more cohesively in preventing unnecessary admissions to local A&E units around the country.

The shortage in beds due to emergency admissions has had a heavily detrimental impact on planned operations; in January, because of seasonal pressures, the NHS postponed or cancelled “numerous” operations and, as a result, there were 23,000 fewer operations that month than the previous year.

The committee, led by Meg Hillier, said it was “frustrating” that 24% of emergency admissions were avoidable if people had more effective community health care and case management to prevent them getting so unwell that they needed emergency hospital care.

“It is lamentable that nearly 1.5 million people could have avoided emergency admissions in 2016–17 if hospitals, GPs, community services and social care had worked together more effectively,” the PAC said.

“It is frustrating that NHS England and partners are making some progress in reducing the impact of emergency admissions for patients and hospitals when they do happen, but no impact on reducing the numbers of admissions that could have been avoided.

“NHS England needs to deliver on its five-year plan to move care into the community and out of hospitals. This move is overdue.”

An ageing population, uncoordinated sharing of services between primary and social care, and soaring bed occupancy rates were amongst the reasons for the increase in emergency admissions. 

The average number of available hospital beds dropped by nearly 6% from 2010 to 2016-17, largely due to a lack of investment in community and social care, which causes ‘bed-blocking’ – where patients are medically fit enough to leave hospital but are unable to receive community care at home, so have to stay on the wards.

MPs have laid the blame on NHS England’s feet: “Without a better understanding of what works best to reduce emergency admissions, NHS England cannot prioritise resources effectively.

“NHS England is trying to reduce emergency admissions with various interventions in several different programmes, including the urgent and emergency care programme, new care models and the Better Care Fund. However, neither NHS England nor NHS Improvement know what is most effective at reducing emergency admissions,” the report said.

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