Letters Reducing emergency admissions

Shortage of services in the community must be dealt with

BMJ 2012; 345 doi: https://doi.org/10.1136/bmj.e6908 (Published 17 October 2012) Cite this as: BMJ 2012;345:e6908
  1. Siddappa Gada, general practitioner1
  1. 1Holbrook and Shotley Practice, Shotley Surgery, Ipswich IP9 1ND, UK
  1. drgada{at}doctors.org.uk

The approach that has been taken in primary care to reduce emergency admissions is somewhat naive.1 Most patients would prefer to be managed in the community. Because of the high cost of emergency admissions, commissioning groups are trying to highlight the issue among surgeries. Some regions have a policy of “naming and shaming” practices with high emergency admissions.

But the root cause must be dealt with if we want to reduce emergency admissions in the long term. We need to identify services that are missing in the community, with planned measures on how to reinstate them so that patients can access them when needed. This would mean that patients could be dealt with in the community rather than ringing the emergency services and being admitted to hospital (unwillingly most of the time).

We get monthly PARR (patients at risk of rehospitalisation) data for our practice patients and we have monthly multidisciplinary team meetings to reduce emergency admissions. We do try to discuss how to rectify potential problems for patients to reduce future admissions. But the shortage of various services in the community needs to be dealt with to see real benefits.


Cite this as: BMJ 2012;345:e6908


  • Competing interests: None declared.


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