RCEM: emergency care metrics are crucial for improving patient safety and experience

The latest Hospital Episodic Statistics (HES): Hospital Accident and Emergency Activity 2020-21 published today by NHS Digital and NHS England show that attendance rates in the most deprived areas of England were almost double the attendance rates in the least deprived areas.

The data show in 2020-21 in the most deprived areas of England there were 39,161 attendances per 100,000, while in the least deprived areas this figure is almost halved to 20,784.

Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said:

“The pandemic has highlighted the scale of health inequalities across the country. The data show that those from the most deprived area are almost twice as likely to visit their Emergency Department than those from the least deprived area. We welcome NHS England’s willingness to engage on the issue and address health inequalities, but we must see real action taken. We also look forward to the formation of the Office for Health Improvement and Disparities (OHID) and would welcome the opportunity to input into their agenda.

“The health inequalities are clear and tackling them will be a serious challenge. On a fundamental level, if the government is serious about levelling up and tackling these inequalities, the first steps must be to fund and support local authorities and Integrated Care Systems and invest in preventative health. The scale of health inequalities means tackling homelessness; immigrant health; domestic violence; and youth violence. While supporting those with; mental health illnesses; learning disabilities; and both drug and alcohol addiction.”

There were also 1.39 million reattendances in 2020/21 which is equal to 10.4% of all unplanned attendances. This is the highest figure on record and up 1.7 percentage points when compared to the previous year 2019/20.

Dr Henderson continued:

“It is also deeply concerning that one in ten patients reattended the Emergency Department (ED), it is vital that patients have the appropriate information and support available to manage their condition following their visit to the ED. We need better data on this issue to understand what is driving people to reattend.”

In 2020/21 302,784 patients stayed in an Emergency Department for 12-hours or more from time of arrival, this is 21 times higher than the 12-hour figure from decision to admit, which is 14,150.

Dr Henderson continued:

“Utilising the right metrics in Emergency Departments is crucial to improving patient safety. It is vital that we measure health equalities, reattendances, and 12-hour stays from time of arrival across the country. Analysing these metrics will help us, NHS England and the government to take effective action to support the patients, communities and areas that need it most. That means fewer reattendances, closing the gap on health inequalities, reducing long stays, and improving the patient experience.

“This data paints a very real picture of the state of health and the state of healthcare in this country. We welcome the engagement of NHS England and the government’s agenda on these matters, but we must now see the tangible actions taken to tackle these issues.”