Need to strengthen community services to prevent emergency admissions
02 March 2018
The National Audit Office has published its report on reducing emergency admissions.
It argues that emergency admissions cost the NHS £13.7bn in 2015-16 and pose a serious challenge to both the service and financial position of the NHS.
The report finds that:
- Overall emergency admissions grew by 24% from 2007-08 to 2016-17.
- In 2016-17, there were 5.8 million emergency admissions of which 24% were considered avoidable by NHS England.
- Most (79%) of the growth in emergency admissions from 2013-14 to 2016-17 was caused by people who did not stay in hospital overnight.
The report also notes that capacity in the community to prevent emergency admissions does not currently meet demand.
Responding to the findings, the deputy chief executive of NHS Providers, Saffron Cordery, said:
“The NAO is right to point to the health service’s success in managing the impact of increased emergency admissions on hospitals.
There is encouraging evidence that some of the vanguard sites have started to help stem the rise in emergency admissions in those communities.
“NHS trusts have been at the forefront of initiatives to reduce emergency admissions in the face of demographic pressures leading to an older, sicker patient population.
“There is encouraging evidence that some of the vanguard sites have started to help stem the rise in emergency admissions in those communities.
“The NAO report shows that although admissions have increased, trusts have been cost-effective at managing the additional demand, and have coped well despite the number of beds reducing by around 6% between 2010 and 2017.
“On top of this, trusts have had to cope with reduced tariff payments for admissions.
“We agree there is a need for better data to understand properly the rise in re-admissions and avoidable admissions, and the drivers behind the increase in short stay admissions.
A lack of capacity out of hospital care to deal with growing demand for treatment has had a knock on impact on trends in admission.
“But what is clear, as the NAO rightly points out, is a lack of capacity out of hospital care to deal with growing demand for treatment, has had a knock on impact on trends in admission.
“Figures published earlier this week by NHS Digital showed ongoing reductions in numbers of community nurses, and we were disappointed last month to hear that plans to create a ‘forward view’ for community services had been dropped.
“NHS community services are central to the ambitions – set out in the Five Year Forward View – to improve prevention and deliver more care closer to home.
“Although there is some excellent work and innovation in this field, it is clear that historically NHS community services have not been given enough priority, and have been underfunded. That must change.”