In the week of December 8-14, 440,428 people walked through the doors of A&E departments in England. In the equivalent week in 2011, that figure was just 398,930.
The biggest users of hospital A&E units are older people, we’re frequently told, often presenting with more complex conditions. And the reason for hospitals closing their A&E units temporarily after declaring an incident, is because they’ve been overwhelmed by a surge in demand.
Now a report by Quality Watch, an initiative of the Health Foundation and Nuffield Trust think tanks reveals some surprising facts. They’re outlined in a commentary by Andrew Gilligan – (see the link at the bottom.)
- Among the heaviest users are people in their twenties. This age group is among the healthiest in society – but they visit A&E more often than people in their sixties and seventies.
- 20% of A&E attendances are alcohol related. The figures rises to 80 per cent during peak weekend periods on Friday and Saturday nights
- ‘Attendances at the major [Type 1] A&E units, where waits are a significant issue, have only increased in line with population growth – there has not been a great surge in attendances’.
- Even if patient numbers are not rising much, are their needs becoming greater – particularly since more are old? Not really, said the researchers: ‘We did not find evidence that cases seen in A&E were becoming more complex.’ The figures bear this out; the proportion of Type 1 A&E attendees needing to be admitted as inpatients has barely risen in the last three years.
- Remarkably, 52 per cent of those who come to A&E are sent away without needing treatment, or given only “guidance and advice”.
- In the last quarter of 2014, more than 11 per cent of patients using England’s full-service A&Es, the “Type 1” units, had to wait longer than four hours, rising to almost 17 per cent in the week before Christmas.
- Factors impacting on A&E were patients not being able to make appointments with their GPs, and a shortage of emergency doctors, although recruitment of the latter has increased over the last decade more than other specialisms.
- Two thirds of patients come to A&E during normal working hours.
- Each year, more than one million hospital admissions in England are alcohol related. Over the last decade, such admissions in those aged between 15 and 29 have risen by almost 60 per cent.
Dr Cliff Mann, the president of the College of Emergency Medicine, which represents A&E doctors, has urged police to adopt a ‘zero tolerance’ towards binge drinking that would see troublesome drunks arrested, charged and given a criminal record. If they knew they would be arrested they wouldn’t binge drink in the first place, he avers. And ‘police forces should mount campaigns over several successive weekends against those who are drunk and disorderly to try to reduce the numbers needing help from A&E staff and diverting resources from patients he said were ‘more deserving’.
It seems that many of young people have nothing better to do at the weekend than get deliberately drunk to the point that they need emergency care. How nihilistic is that? How sad. Doctors are calling for measures to prevent it.
And how many grandmas and granddads have had to wait for hours in an ambulance or on a trolley while they were being attended to?
Read the reports here: