Emergency hospital admissions 'unsustainable' for NHS

Dr Jennifer Dixon of the Nuffield Trust and Dr John Heyworth of the College of Emergency Medicine

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The rise in emergency admissions to hospitals is "overheating" the system in England and is "unsustainable" in the future, a health think tank says.

Analysis by the Nuffield Trust found there were now 4.9 million unplanned admissions a year - a rise of 12% since 2004-05 - costing the NHS £11bn a year.

It said a rise in patients who spent a day or less in hospital suggested many admissions could be avoided.

NHS managers agreed action was needed to tackle the problem.

Emergency admissions include patients admitted through A&E units as well as direct into other parts of hospitals.

Ageing population

The think tank, which analysed a range of official NHS data during its research, found emergency admissions now accounted for more than a third of the total.

The rise seen since 2004-05 is costing the NHS an extra £330m a year alone and the think tank said the issue had to be a priority if the NHS was to prosper in the current economic climate.

Researchers found there was a range of factors behind the trend.

They pointed to the ageing population - the elderly were more likely to be admitted as an emergency - as well as financial incentives in the NHS which were motivating hospitals to admit more.

The report also noted there had been a significant jump in patients being admitted for one day or less.

Start Quote

This report furthers the case for fundamentally reviewing the urgent and emergency care system”

End Quote Nigel Edwards, NHS Confederation

It said this was partly related to advances in medicine which meant patients did not need to spend as long in hospital, but argued many could have been avoided with better community services.

While the report only looked in detail at the situation in England, it also noted rises had been seen elsewhere in the UK.

And it said the recent announcement by ministers that hospitals would be fined for readmissions would only have a limited impact as many of the cases did not fall into that category.

Nuffield Trust director Dr Jennifer Dixon said: "Reversing this unsustainable rise in emergency admissions must be the number one priority for the NHS - any reform to the health service that does not tackle this will fail.

"Our hospitals are overheating and are treating patients at great cost to the NHS."

Nigel Edwards, acting chief executive of the NHS Confederation, which represents managers, said: "This report furthers the case for fundamentally reviewing the urgent and emergency care system.

"Hospital is often the right place for sick patients to be but we know that for many there are better, more convenient and more cost-effective alternatives to hospital admission.

Dr John Heyworth, president of the College of Emergency Medicine agreed there were pressures in the system, but questioned some aspects of the research.

"It is fundamentally incorrect to assume that admissions for less than 24 hours are unnecessary or financially inefficient. In fact, the opposite applies."

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