Intended for healthcare professionals


Almost 1.5m emergency hospital admissions could have been avoided last year

BMJ 2018; 361 doi: (Published 07 June 2018) Cite this as: BMJ 2018;361:k2542
  1. Ingrid Torjesen
  1. London, UK

Almost 1.5 million emergency admissions to hospitals could have been averted last year if the NHS had invested in better preventive care outside hospital, says a report from MPs.1

There were 5.8 million emergency admissions in England during 2016-17, of which 24% might have been avoided if people had had more effective community healthcare and case management to stop them becoming so unwell that they needed emergency hospital care, said House of Commons Public Accounts Committee.

The proportion of avoidable admissions has been rising faster than the overall rate of emergency admissions since 2013-14, and Meg Hillier, chair of the committee, said that the report “laid bare” the consequences of the government’s failure to properly fund and coordinate preventive healthcare and social care.

“The benefits of work to reduce the impact of emergency admissions will inevitably be limited until hospitals, GPs, community services, and social care work better together to drive down the level of avoidable admissions,” she said.

“NHS England and NHS Improvement must take a lead here and move swiftly to better understand the stresses across the health and social care sectors and their implications. A priority must be to properly identify the impact of measures intended to reduce emergency admissions and explain how this information will be used to target scarce resources effectively.”

The committee said that data collection needs to be improved, so that by the end of 2018 care can be tracked and publicly reported, together with a clear statement of what is a harmful level of readmissions for people’s care.

NHS England should identify gaps in capacity in primary and community health care and set out how it intends to fill those gaps, it says, and consider the impact of pressures on social care provision on emergency admissions so that it can inform the forthcoming green paper on future funding of social care.

The average number of available hospital beds dropped by nearly 6% from 2010 to 11 to 2016-17, with occupancy peaking at 91.4% in the first three months of 2017. The committee urged NHS England and NHS Improvement to assess the capacity that hospitals need in terms throughout the year and provide trusts with greater certainty of additional funding to cope with winter pressures earlier in the year.


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