How data can reduce visits to A&E

In June 2014, hospital accident & emergency departments recorded their highest weekly attendance figures since records began. This unusual peak (figures usually dip in the summer) is a sign of the increasing strain facing the NHS, which is under huge financial pressure and shouldering the burden of an ageing population.

This statistic comes as your local GP approaches a deadline to sign up to a new initiative to identify those of us most at risk of unplanned admissions to hospital, and to co-ordinate our care more effectively in the community to avoid this.

The concept is welcome, but it has its doubters. Can such patients really be identified? Won't identifying them and paying more attention to their care just highlight more reasons they need to go to A&E? Won't this simply shift pressure from A&E departments to GP practices?

Nobody has a crystal ball - we won't know for some time whether this new focus on reducing unplanned admissions will work. But what I do already know is that data is the key to its potential success.

Identifying those of us 'at risk' of being admitted to hospital is not just possible in theory. It is happening right now because of data analysis. The GP computer system EMIS Web, for example, has a tool enabling GPs to identify patients who are most likely to require an unplanned A&E admission. While protecting patient confidentiality, it highlights those with, for example, high level of previous unplanned hospital admissions or who are taking multiple medications for a number of different conditions.

Of course, identifying at risk patients is just the first step. Arguably the more challenging task is for doctors, district nurses and the wider community healthcare team to work together and co-ordinate treatment so that patients receive the best possible care; care that reduces the likelihood of needing to visit A&E.

I stress the word 'co-ordinated' because this is where attempts have failed in the past. The responsibility should not, and cannot, rest with the GP alone - it needs to be shared between all those involved in a patient's care. Including patients themselves

Here too, data is key. Co-ordinated care is impossible without everyone involved having a true and 'real time' understanding of a patient's condition and that can only come from secure and intelligent patient record sharing.

Camden clinical commissioning group (CCG) is the perfect case in point. They are using risk assessment coupled with co-ordinated care to reduce admissions. GPs, hospital and community nurses, social carers and mental health professionals can all securely share vital medical information (with patient permission) to deliver care that ensures vulnerable patients don't fall through the net and end up in hospital.


The result? A 47.7% drop in A&E attendances in a year. Camden is just one example. But for me it demonstrates that information sharing can not only save money but also help vulnerable patients. Data alone cannot provide the answer, but it is vital to help healthcare staff to give better, safer care - and an essential part of solving the A&E crisis.

This article was written by Chris Spencer.

The original article can be read on The Huffington Post.