It is widely perceived that the NHS emergency and urgent care system is close to breaking point. There have been year on year increases in demand for emergency and urgent care for a long period, placing strain on the individual parts of the system, such as the ambulance service, emergency department (ED) and acute hospital wards.
A particular challenge for emergency and urgent care services is dealing with the large number of patients presenting with long term conditions, including those older patients who often have multiple problems. While it is appropriate for the majority of patients attending the ED to do so and most patients are admitted as an emergency appropriately, there are a substantial number of patients who will be amenable to an alternative approach to hospital care when they have an urgent medical event.
There is currently a lack of research evidence for which patients are likely to benefit from this alternative more community based approach to care and hence we wish to undertake a detailed analysis of ED and inpatient data collected by all hospitals in Yorkshire and Humber. This will identify specific groups of patients by clinical condition, age and other demographic characteristics who attend hospital but who are likely to benefit for an alternative care pathway. Patients with particular patterns of attendance to ED (e.g patient discharged home same day without investigation) or admittance to hospital (admitted for less than 48 hours) will be identified and described. In this way specific groups of patients (e.g mental health, diabetes or frail older people with multiple conditions) who can be the focus of alternative service provision will be identified.