Thousands of patient visits pile pressure on Wigan NHS

A Wigan NHS boss recently called for a better response to patients with alcohol problems
A Wigan NHS boss recently called for a better response to patients with alcohol problems

Tens of thousands of patients attend A&E more than 10 times a year with 10 patients making 2,000 visits between them, new research has revealed.

An analysis of NHS hospital data by the healthcare statistics company, Dr Foster, found that 31,492 people visited A&E in England 10 or more times between June 2017 and May last year.

Between them, the group of so-called high-intensity users attended emergency departments 522,312 times, the equivalent of about 16 times each during the 12-month period.

Last year a Wigan NHS boss called for a better response to patients with alcohol problems after one ended up in A&E 28 times in just four weeks.

Director of operations and performance at Wrightington, Wigan and Leigh (WWL) NHS Foundation Trust, Mary Fleming, took to social media to say a particular patient had visited Wigan Infirmary an astonishing 126 times in the space of a few months including the person arriving at casualty five times in a 24-hour period.

She described the pressure repeat admissions puts on the NHS including hospital and ambulance staff and police officers.

The figures published today, also found that 10 patients visited A&E more than 235 times each, with some attending on average in excess of once a day and just 0.4 per cent of patients made up 4 per cent of all A&E attendances.

The firm said this suggested this small group was receiving a “significant allocation of NHS resources” compared to the average population.

The report revealed in 2016 patients that attended more than 20 times in 12 months accounted for 0.05 per cent of A&E visitors but cost the NHS £53m.

It said this put more pressure on NHS services and contributed to the rising cost of healthcare, but also suggested this group of patients’ needs was not being met.

It added: “As well as generating high healthcare costs, HIUs also increase the risk of overcrowding in emergency departments, affecting the safety and care that can be offered to other patients.

“This relatively small proportion of patients can, therefore, have a significant impact on limited NHS resources and, as such, presents an opportunity to reduce the strain on emergency services.

“It is also important to understand why high intensity users are visiting A&E so frequently, their needs are potentially not being addressed elsewhere in the system one way or another, whatever the root cause of their visits.”

Researchers found that about high intensity users are more likely to live in more deprived areas, be aged 21 to 31 and to visit A&E at night.

The most common condition they are admitted to hospital with is chronic obstructive pulmonary disease, but also chest and abdominal pain, poisoning by drugs, medications and psychotropic agents and alcohol-related disorders.

The new report sets out a number of ideas to improve support for high intensity attenders including A&Es and paramedics working together to identify them and their reasons for attending then providing more targeted and integrated support to help them manage their health in the community.

It also called on the government to invest more in public health programmes to support the physical and mental health of younger people, particularly around alcohol and drug misuse.

An NHS England spokesman said the RightCare High Intensity User programme was being rolled out across more of the country following a successful trial in Blackpool that reduced A&E visits by 90 per cent and saved the NHS more than £2m.

He added: “The NHS long-term plan sets out a range of options for people to get urgent and emergency care outside A&E, including NHS 111 online and seven day crisis care for mental ill health.

“This is precisely the sort of supportive and positive action that is improving patient care while reducing pressure on services the NHS, which will be ramped up through the long-term plan for the NHS.”