The Public Accounts Committee (PAC) has said that improvements are needed in preventative care to reduce emergency admissions. Its report warns that hospitals, GPs, community services and social care need to work together more effectively. It says that emergency admissions to hospitals continue to rise, despite the NHS’s efforts to reduce them.
The PAC says that it is lamentable that nearly 1.5 million people could have avoided emergency admissions in 2016–17 if hospitals, GPs, community services and social care had worked together more effectively. It says that it is frustrating that NHS England and partners are making some progress in reducing the impact of emergency admissions for patients and hospitals when they do happen, but no impact on reducing the numbers of admissions that could have been avoided.
Adding that NHS England needs to deliver on its five-year plan to move care into the community and out of hospitals. A move it says is overdue.
Reducing emergency admissions makes a number of recommends:
- NHS England should identify gaps in capacity in primary and community healthcare and set out how it intends to fill those gaps. It should also consider the impact of pressures on social care provision on emergency admissions and use this understanding to inform discussions with the Ministry of Housing, Communities and Local Government and HM Treasury about the Green Paper on future funding of social care.
- NHS England’s and NHS Improvement’s regional teams should assess the capacity that hospitals need in terms of beds, staff and funding to deal with emergency admissions throughout the year. The PAC has previously highlighted the need for Trusts to have greater certainty earlier in the year of additional funding to cope with winter pressures.
- The Department should encourage better sharing of best practice on how the voluntary sector supports health and social care efforts to reduce emergency admissions and understand the reliance the system has on the sector. It should report back to the Committee on this.
- NHS England and NHS Improvement should set out their plans for how and by when they will determine which interventions are most effective at reducing emergency admissions and how they will use any findings to ensure a more targeted use of resources and funding.
- NHS England and NHS Improvement should improve data they collect and that hospitals record so that by the end of 2018 care can be tracked and publicly reported, together with a clear statement of what is a harmful level of readmissions for people’s care.
Committee Chair, Meg Hillier MP commented, 'The consequences of Government’s failure to properly fund and co-ordinate preventive healthcare and social care are laid bare in this report. Around a quarter of emergency admissions to hospital could and should have been avoided. That they were not further threatens the ability of cash-strapped hospitals to cope with demand and risks harm to patients through, for example, unnecessary overnight stays or the postponement of operations.
'The benefits of work to reduce the impact of emergency admissions will inevitably be limited until hospitals, GPs, community services and social care work better together to drive down the level of avoidable admissions. NHS England and NHS Improvement must take a lead here and move swiftly to better understand the stresses across the health and social care sectors and their implications. A priority must be to properly identify the impact of measures intended to reduce emergency admissions and explain how this information will be used to target scarce resources effectively. The financial challenges facing the NHS and adult social care are well-documented and it is critical that taxpayers’ money is spent on what works best.'