Many emergency admissions to hospital are avoidable and many patients stay in hospital longer than is necessary. This places additional financial pressure on the NHS as the costs of hospitalisation are high. Growth in emergency admissions is a sign that the rest of the health system may not be working properly. Making sure patients are treated in the most appropriate setting and in a timely manner is essential to taking the pressure off emergency hospital admissions” (Amyas Morse, Head of the National Audit Office, 31 October 2013).
The total number of older (65 and over) Derby residents admitted to hospital in 2012/13 was 11,904, amassing 24,129 admissions. Of those, 86% spent less than 3 days in hospital, 7% spent 3-6 days and 7% spent 6 days or more. The GP registered population of Southern Derbyshire NHS Clinical Commissioning Group (CCG) make use of local urgent care provision at levels expected for the population demographic. However, considerably more individuals telephone for an ambulance from a home address resulting in proportionally more ambulance arrivals at the Royal Derby Hospital (RDH) when compared with the national average – 1 in 3 individuals are brought in by Paramedics. As such, ‘Major’ categorised attendances to the A&E Department of RDH have been increasing in recent years while the trend of non-elective (emergency) admissions to hospital has been steadily reducing. A total of 146,047 A&E attendances were made by patients of Southern Derbyshire CCG in 2012/13; 10,000 of which had been picked up from a home address. An understanding of the epidemiology of presentations to A&E can be used as a predictor of activity each year. For instance, in the seasonal variation of diagnoses such as respiratory disorders in the winter and gastrointestinal disorders in the spring.