This item was published during the term of a previous administration that ended in April 2007
Listen
NHS to tackle rising emergency admissions
06/02/2004
New initiatives to reduce emergency admissions to
Scotland's hospitals are being considered in Edinburgh
today.
Alongside a conference a new report,
Decide to Admit v Admit to Decide, is also published by
the Centre for Change for Innovation. The report sets out
proposals for the NHS to consider in improving its service
to patients.
Emergency medical admissions to hospitals rose from
around 270,000 in 1981 to 450,000 in 1999. Between 1985-95
there was a doubling in the number of over 65s who were
admitted as an emergency four or more times in a five-year
period.
Four key issues are tackled in the report and will be
discussed at the conference. These are:
* Whole System Working - ensuring that the social,
primary and secondary care sectors work better
together;
* Improving Support Services - ensuring alternatives to
hospital admission including investing in rapid response
teams and home support;
* Workforce/Training Issues - breaking down professional
barriers including extending skills amongst care staff to
allow them to take on more responsibilities; and
* Changing Culture and Behaviours - a fundamental shift
is required among professional groups to embrace new ways
or working.
Health Minister Malcolm Chisholm said:
"The continuing rise in emergency medical admissions to
Scottish hospitals has been the greatest single source of
pressure on the NHS. They now account for around two thirds
of all inpatient admissions to acute specialities.
"This increase has been most marked amongst older
people, who make up some 37 per cent of emergency
admissions. This is of particular concern because it is
this group of patients whose discharge from hospital is
often delayed. In fact, 90 per cent of delayed discharges
in older people occur after emergency admissions.
"However, there is a complex interplay of medical,
organisational, social and environmental factors. The
solutions we design must tackle these and services must
work together to design an integrated care network that
will secure high quality care for people.
"If we are going to provide the right solutions we must
design services that involve the many professions and
organisations that are involved in planning and providing
care but crucially with the patient at the centre of the
redesign of any service."
There are already good examples of work underway across
Scotland, including:
* Nurse-led minor injuries units, including one at the
Western General in Edinburgh which allows patients to be
seen, treated, and discharged without the need for
admission or waiting to see a doctor.
* GPs working in A&E departments have the experience
and the confidence to see, treat and discharge patients
home rather than admitting for assessment. This is
happening in Lothian and Tayside.
* Rapid response services including the MATCH team in
Paisley which includes district nurses, occupational
therapists, dieticians, social work staff, physiotherapists
and home care staff working together to help the patient
remain at home rather than being admitted to hospital.
* Treatment-at-home services are being piloted,
including in the Western Isles where new services are being
developed to treat serious or chronically-ill patients in
their own homes.