One in seven emergency room patients is a repeat visitor with unmet medical needs and who feels like they have nowhere else to go. Research shows that most are over 70 years old with multiple conditions or under 50 years old with a mental illness.
Less than 2% of the population are responsible for almost 14% of all A&E visits, the British Red Cross research suggests. Across Britain, patients turn to A&E five or more times a year for “unresolved medical problems”, the charity said.
“Many of the people who regularly attended emergency departments had often tried to get other care, but it did not meet their needs,” the report says. “This meant that when they reached A&E, they often needed more urgent care.”
The research comes as NHS England’s top A&E doctor urged people to use 111 services this winter and suggested that as many as two in five people arriving at A&E could be better treated elsewhere.
Frontline doctors have sounded the alarm about an impending winter crisis, which they say is already putting patients in overloaded A&E departments at risk.
For the new research, experts from the British Red Cross carried out an in-depth review of returning visitors to emergency departments and also examined five years of data on emergency attendance rates in Dorset.
According to the research, just 1.7% of the Dorset population were responsible for 13.8% of emergency departments. The visits were likely classified as urgent by doctors, the report showed. Frequent visitors were also more likely to live in deprived areas.
The majority of people visiting A&E often fell into two main groups: people over 70, most of whom had multiple long-term conditions; and people aged 20 to 49, especially younger women, with poor mental health.
Both groups came to the emergency room more often by ambulance and both visited the GP more often in the month before their visit to the emergency room.
Béatrice Butsana-Sita, director of the British Red Cross, said: “Every year millions of people go to A&E when they have an accident or are in desperate need of care. But some people need to attend more often than others. There are many reasons that can contribute to this and for these individuals it is very disturbing. It is a situation that any of us can find ourselves in.
“Our research found that almost one in seven emergency visits in Dorset were from less than 2% of the county’s population. Those people needed help and were much more likely to be classified as urgent cases or in need of hospitalization. Our Red Cross teams work with the NHS across the country and regularly see people facing a range of issues, from isolation to inadequate housing and other challenges impacting on health and wellbeing.”
Ministers are developing a 10-year plan to transform the NHS, and Butsana-Sita said the research highlights the need to tackle the root causes of ill health and support community services.
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Professor Julian Redhead, NHS England’s clinical director for emergency care, urged people to use 999 or A&E services only for life-threatening emergencies and serious injuries, otherwise to call 111 or 111 online or via the NHS app to use.
NHS England estimated that up to two-fifths of A&E visits were avoidable or better treated elsewhere. It said NHS 111 could assess and refer people to the most appropriate local service, including urgent treatment centres, GP surgeries or consultations with a pharmacist.
If necessary, NHS 111 can arrange for a nurse, doctor or paramedic to be called back, or provide self-treatment advice over the phone. The 111 service is available 24 hours a day, seven days a week.
Redhead said: “We know that up to two-fifths of emergency departments could be better treated elsewhere, as well as one in six calls to 999 just need telephone advice. That’s why I’d really encourage everyone to use our free 24-hour 111 service which will help millions of people quickly, safely and easily access the advice or treatment they need this winter.”
Health Minister Karin Smyth said the government was supporting the NHS to cope with winter pressures, adding that its 10-year plan would “make the NHS fit for the future all year round”.