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One in four emergency admissions last year ‘avoidable’, NAO reveals

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2 March 2018

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Just under a quarter of emergency admissions in 2016-17 could have been avoided, Government auditors have revealed.

There were 5.8 million emergency admissions in this period, 24% of which were considered ‘avoidable' by NHS England, according to a National Audit Office (NAO) report published today (2 March).

However, although the number of emergency admissions is increasing, they are costing the NHS less.

Just under a quarter of emergency admissions in 2016-17 could have been avoided, Government auditors have revealed.

There were 5.8 million emergency admissions in this period, 24% of which were considered ‘avoidable' by NHS England, according to a National Audit Office (NAO) report published today (2 March).

However, although the number of emergency admissions is increasing, they are costing the NHS less.

The cost of emergency admissions rose by 2% (£300m) to 13.7bn between 2015-16 and 2016-17, despite a 7% rise in this type of admissions during the same period. This ‘therefore suggests that the NHS has become more cost-effective in managing emergency admissions’, the NAO said.

Commenting on the NAO report, NHS England’s medical director for acute care professor Keith Willett said: ‘We’re pleased the National Audit Office recognises the NHS has managed emergency admissions more efficiently over the last four years.’

Avoidable and unavoidable admissions

The NHS differentiates between emergency admissions that are ‘clinically appropriate and unavoidable’ and others that could be avoided by providing different forms of urgent care or support at community-level, the NAO specified in its report.

The report said that ‘there has been a 14% increase in such admissions between 2013-14 and 2016-17 and in 2016-17, patients with such conditions formed 24% of all emergency admissions.

Last month, just over 2 million patients visited all A&E departments with half of them being sent to major A& E departments.

Integration needed

Little evidence has been produced on the effectiveness of programmes set to lower the number of emergency admissions, such as the Better Care Fund and the urgent and emergency care programme, the NAO report concluded.

It suggested that both the Department of Health and Social Care (DHSC) and NHS England should produce more evidence around what works to reduce emergency admissions.

They should also and analyse data from secondary care services together with primary, community and social care data to enable practitioners to ‘make the most informed decision about whether a patient requires emergency hospital treatment,’ it said.

Lack of social care and community services funding

British Medical Association (BMA) council chair Dr Chaand Nagpaul recognised that a growing number of people are being admitted to A&E because of a series of factors, such as ‘an ageing population with people living longer with a range of complex medical needs, but also because of cuts to social care budgets and a lack of capacity in community services’.

He added: ‘It is becoming increasingly clear that the health service just doesn’t have the resource nor capacity to meet rising demand year-round.’

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