Patient safety

Increasing urgent admissions reflect growing NHS pressures

The number of patients admitted urgently to hospital has rocketed by 42% over the past decade, according to new research by the Health Foundation.

The figures reveal that patients arriving in A&E are sicker than ever and more likely to need admission, with the total number of people attending A&E departments up by just 13%.

Patients with multiple co-morbidities are on the rise as one in three patients admitted to hospital as an emergency across England in 2015-16 had five or more health conditions, such as heart disease, stroke, type 2 diabetes, dehydration, hip fracture or dementia.

Back in 2006-07 this figure was just one in ten.

However, overnight stays for patients with five or more conditions are now much shorter, lasting an average of just 10.8 nights in 2015-16 compared with 15.8 days previously.

Furthermore, the number of these patients that are admitted to hospital but then discharged the same days has increased by a whopping 373% over the same period.

The emergency hospital admission briefing identifies opportunities to reduce emergency admissions.

It found that 14% of all emergency admissions are for ‘ambulatory sensitive’ conditions such as asthma, where timely and effective primary care could reduce the likelihood of admission.

The report argues that were older patients to see their regular GP two more times out of every 10 consultations, it would be associated with a 6% decrease in admissions for ambulatory sensitive conditions.

It also claims that over a quarter of all unplanned A&E attendances in England were preceded by the patient being unable to obtain a GP appointment that was convenient to them, although few of these attendances actually resulted in an admission.

Responding to the report, Amber Jabbal, head of policy at NHS Providers, said: “This report highlights the growing pressures NHS trusts face, with a sharp rise in the numbers of patients requiring emergency admission to hospital.

“An important part of the solution in dealing with these pressures lies in prioritising NHS community services to help prevent the need for these admissions, and to facilitate prompt discharge when patients are ready to leave hospital.”

This briefing follows a report by NHS Providers that contains examples of innovation and good practice.

Jabbal added: “However, the failure to follow through on repeated ambitions to strengthen community services means these have not been developed at scale.

“We need to seize the opportunities presented by the push for integrated care and the prime minister’s commitment to increase long term health and care funding to make good on past promises, and bring NHS community services centre stage.”

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