Shop floor experience suggests a rise

EDITOR—Morgan et al report that they find little evidence for a rise in emergency admissions from NHS data returns.1 Their conclusion is that much of the increase in admissions is due to internal transfer between consultants generating multiple finished consultant episodes for an individual patient's admission My memory suggests that this was a prediction raised in letters to the BMJ when the finished consulting episode first became a recognised measure of hospital activity.

In accident and emergency our level of information technology is often more basic and our workload is dependent on the number of …