Reducing emergency admissions: Report by the Comptroller and Auditor General

E-books

50 pages

<ol></ol><span style="font-size: 10pt;">NHS England defines an emergency admission to be ‘‘when admission is unpredictable and at short notice because of clinical need’’. Some emergency admissions are clinically appropriate and unavoidable. Others could be avoided by providing alternative forms of urgent care, or by providing appropriate care and support earlier to prevent a person becoming unwell enough to require an emergency admission. Increasing emergency admissions lead to increasing pressures across the health and social care systems. Prolonged overnight emergency admissions can have a significant impact on people, particularly older people who can lose mobility very quickly if they do not keep active, and their ability to perform everyday activities can reduce while in hospital. Increasing emergency admissions can limit a hospital’s capacity to undertake routine elective care. Efforts to reduce emergency admissions can create additional demand for general practice and local authorities’ social services. The cumulative impact of rising emergency admissions is an increased challenge to the financial and service sustainability of the NHS and the already under-pressure acute hospital system.The Department of Health & Social Care (the Department) sets NHS England’s mandate for arranging the provision of health services. The 2017-18 mandate includes an objective for NHS England to achieve a measurable reduction in emergency admission rates by 2020. The Department and its arm’s-length bodies have an internal ambition to reduce growth in elective and emergency admissions in 2017-18 to 1.5%. NHS England recognises that reducing emergency admissions requires action across the health and social care systems, rather than focusing on activity in accident and emergency (A&E) departments alone. NHS England is aware that there is a direct trade-off between funding going to acute hospitals and funding spent on out-of-hospital services.</span>