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Changing picture of A&E activity revealed in new report

More elderly people attending major units and almost half are admitted

Ingrid Torjesen

Tuesday, 03 December 2013

The Health and Social Care Information Centre (HSCIC) has today published a new report showing the changing and complex picture of overall attendance in A&E in England.

Focus on Accident and Emergency, December 2013 shows that in 2012-13 A&E department dealt with 21.7 million attendances overall - or 60,000 a day. This is an 11 per cent growth in four years (since 2008-09); during this time the population in England grew at only 3.2 per cent over the same period.

Most patients went to major units, which dealt with 66 in every 100 patients (down from 69 four years ago). Minor units dealt with almost 32 in every 100 attendees (up from 28 in 2008-09). In terms of age, 63 in every 100 minor unit attendees were aged under 40 (up from 59 in 2008-09), while 12 in every 100 were aged over 64 (down from 14). In major units, 54 in every 100 attendees were aged under 40 (down from 57 in 2008-09), while 21 in every 100 were aged over 64 (up from 19).

The majority of attendances were during normal working hours of 9am to 6pm and around one A&E patient in five is admitted to hospital. For people aged over 64 this rises to almost one in two.

Of every 20 attendees, 13 refer themselves while around one is referred to an A&E by a GP. About a third of patients receive guidance or advice only when attending A&E.

Dr Mark Porter, chair of BMA Council said: “Rising attendance rates coupled with the Government's drive to do more with less mean many emergency departments are under extreme pressure and are close to capacity.

“To alleviate pressure and reduce unnecessary attendance we need to ensure patients know how and where to access appropriate care and that they get the right advice first time round."

He added that the most deprived make up the greatest proportion of attendees at emergency departments, and that was an issue the Government needed to urgently address, and “the fact one in two elderly patients attending an emergency department are admitted to hospital, often because of poor access to more appropriate community based services".

“Greater support is also needed for staff who are working flat out to meet rising demand, in extremely stressful and at times unsustainable work environments,” he said.

Health Minister Lord Howe said: “A&Es are performing well and meeting national targets, despite seeing more patients. But, as these data show, we know there’s more pressure on the system and we’ve taken action to address this.

“We’re investing £400 million in measures to relieve short-term winter pressures and, longer term, we’re integrating health and social care and bringing back the link between GPs and elderly patients, to enable more people to receive the treatment they need away from A&E.”

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