Reducing emergency admissions

National Audit Office
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This report examines progress in reducing the impact of emergency admissions on acute hospitals in England. It takes a whole-system approach, and looks at action across acute, primary, community and social care systems rather than focusing on A&E departments alone. The report finds that overall emergency admissions continue to increase each year. They have grown 9.3% from 2013-14 to 2016-17, with a large proportion of this growth accounted for by people who did not stay in hospital overnight. In 2016-17, there were 5.8 million emergency admissions, up by 2.1% on the previous year – nearly a quarter of these were admissions that NHS England considers could be avoidable. The data however shows that the cost of emergency admissions has not increased in line with the growth in numbers, suggesting that the NHS has become more cost-effective in managing emergency admissions. Challenges in reducing emergency admissions highlighted in the report include: bed closures, the increase in the number of people being readmitted in an emergency shortly after an initial inpatient stay, insufficient capacity in the community to prevent emergency admissions, local variation in the rates of emergency admissions, lack of adequate overall data on emergency admissions, and lack of linked data across health and social care to allow assessment of the impact of out of hospital care. The report recognises that NHS England and partners have developed a number of national programmes that aim to reduce the impact of emergency admissions while also acknowledging that the rate of growth in emergency admissions has slowed slightly in 2016-17. It cautions however that there is limited evidence to show that initiatives such as the Better Care Fund and the urgent and emergency care programme have brought about the slow down. (Edited publisher abstract)

Subject terms:
emergency health services, hospital admission, Better Care Fund, integrated care, NHS, data collection;
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