23 rd September 2009 NHS Ayrshire & Arran The Key Points from: - - PowerPoint PPT Presentation

23/09/2009

B Samuel 2009

HEAT Targets: Network Event

23rd September 2009

NHS Ayrshire & Arran The Key Points from: The Early Analysis of Patients Presenting at A&E

Bryan Samuel: Senior Information Analyst (A&E)

23/09/2009

B Samuel 2009

The HEAT Target T10 The HEAT Target T10

• Deliver local Improvement Trajectories

– A reduction in unplanned presentations at A&E – Metric: Average attendance/100,000 population – Target: Q4 2010/11 to be below Q4 2007/08

• Sustain the maximum 4hr A&E treatment limit

– From registration to discharge/admission/transfer

• Improve whole systems winter planning
• Improve access to emergency care

Deliver Sustain Current Focus of Analysis

23/09/2009

B Samuel 2009

A& E Data Requirements A& E Data Requirements

• 4 hour A&E Treatment Limit

– Provide data for weekly performance reviews

• Parameters of Interest: A&E Demand Profiles, Time-

to-Triage, Time-to-First-Consult & Total-Patient-Wait

– This is relatively straight forward!

• Reducing Unplanned A&E Attendance

– Need to identify and redirect suitable patients to more appropriate non-A&E treatment paths – This is more of a challenge!

23/09/2009

B Samuel 2009

Daily A& E Performance Data Daily A& E Performance Data

23/09/2009

B Samuel 2009

Reducing Unplanned A& E Reducing Unplanned A& E Attendance Attendance

1. We need to understand our baseline position

– How are the profiles of A&E patients changing? – Can patients be grouped into logical categories? – How many patient groups are appropriate for A&E?

2. Why are inappropriate patients attending A&E?

– Are there more suitable treatment pathways available? – If not, can we use our resources to put them in place? – Once alternatives are available, how can we change patient behaviour?

This is where we are currently! There are plans to collect more of this information

23/09/2009

B Samuel 2009

The Focus of Our Analysis The Focus of Our Analysis (so far...) (so far...)

• March 2009

– A&E Attendance by Triage Category:

• Patient Disposition, Referral Method, Age Profile,

Postcode Area & Distance to A&E

• May 2009

– A&E Attendance by Gender:

• Age Profiles & Referral Method

– A&E Attendance by the 17-35 Age Group:

• Referral Method by Gender & Disposition by Gender
• August 2009

– A&E Attendance age & gender profiles from 1999-2008:

• A look at demographic trends over this timescale

23/09/2009

B Samuel 2009

EADT Information Network 6th March 2009

NHS Ayrshire & Arran Crosshouse Hospital A&E Attendance Review

Stewart Cardwell

Service Improvement Lead - Patient Access

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran E mergency Access R eview A&E Attendance by Triage C ategory 1st Nov 2007 - 31st Oct 2008 G reen 31353, 48% R ed 335, 1% Blue 1078, 2% Orange 5673, 9% Yellow 25560, 40%

Red: Immediate Resuscitation (1) Green: Standard (4) Orange: Very Urgent (2) Blue: Non-urgent (5) Yellow: Urgent (3)

23/09/2009

B Samuel 2009

Blue/Green Patients! Blue/Green Patients!

• By definition these are:

– non-urgent and standard patients

• They make up 50% of A&E Attendees
• The best chance of identifying some

patients suitable for non-A&E routes?

• At least they deserve a closer look!

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran E mergency Access R eview A&E Attendance (% of Total) by Triage C ategory (Triage = Blue/G reen) 1st Nov 2007 - 31st Oct 2008 23.7% 9.1% 6.4% 4.5% 3.8% 1.3% 1.0% 0.4% 0.3% 0.1% 0.0% 0.0% 0.0% 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% D i s c h a r g e n

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e v i e w D i s c h a r g e t

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P A d m i t R e f e r t

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& E C l i n i c R e f e r t

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P L e f t B e f

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e A s s e s s m e n t O t h e r D i s c h a r g e t

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D O C W a r d a s O P A d m i t O t h e r H

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p i t a l M a t e r n i t y R a p i d R e s p

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s e E P A S Disposition Attendances

Almost a quarter of all patients are B/G & are discharged from A&E with no review Over 1% of all A&E patients are B/G & leave before being assessed

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran E mergency Access R eview A&E Attendance (% Total) by R eferral - 'Discharge No R eview' 1st Nov 2007 - 31st Oct 2008 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% R eferral S

• urce

Attendances

DNR 21.2% 1.0% 0.9% 0.9% 0.3% 0.3% 0.1% 0.1% 0.1% 0.0% 0.0% 0.0% 0.0% S elf NHS 24 999 G P Other ADOC P

• lice

This Hospital Other Hospital Health C are P rovider S chool/C

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lege P rison S

• cial

S ervices

Over 21% of all A&E patients refer themselves & are discharged with no review

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran E mergency Access R eview A&E Attendance by R eferral - 'Discharge No R eview' (incl LBA) 1st Nov 2007 - 31st Oct 2008 2000 4000 6000 8000 10000 12000 14000 16000 R eferral S

• urce

Attendances

LBA 631 33 112 22 11 5 11 4 1 DNR 12967 619 468 531 199 180 77 64 35 26 9 6 5 S elf NHS 24 999 G P Other ADOC P

• lice

This Hospital Other Hospital Health C are P rovider S chool/C

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lege P rison S

• cial

S ervices

Left Before Assessment Almost 25% of DNRers who arrive by ambulance leave before being assessed!

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran E mergency Access R eview A&E Attendance Age - 'Discharge No R eview' 1st Nov 2007 - 31st Oct 2008 1000 2000 3000 4000 5000 6000 R eferral S

• urce

Attendances

DNR 1639 1260 2221 4903 1978 1429 947 480 326 0 - 5 5 - 10 11 - 16 17 - 35 36 -45 46 - 55 56 - 65 66 - 75 76+

The 17-35s DNRers look to be a significant group

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran E mergency Access R eview A&E Attendance by Town & Mileage - S elf R eferrals (DNR ) 1st Nov 2007 - 31st Oct 2008 500 1000 1500 2000 2500 3000 K i l m a r n

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M a u c h l i n e D a l r y K i l b i r n i e W e s t K i l b r i d e D a r v e l N e w m i l n s N R B e i t h M

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Attendance 5 10 15 20 25 30

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran E mergency Access R eview A&E Attendance by Town & Mileage - Left Before Assessment (DNR ) 1st Nov 2007 - 31st Oct 2008 20 40 60 80 100 120 140 160 K i l m a r n

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M a u c h l i n e N e w m i l n s D a l r y W e s t K i l b r i d e B e i t h P r e s t w i c k M

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s b l

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Attendance 5 10 15 20 25 30

23/09/2009

B Samuel 2009

EADT Information Network 21st May 2009

NHS Ayrshire & Arran Crosshouse Hospital A&E Attendance Review

Stewart Cardwell Service Improvement Lead - Patient Access

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran - C rosshouse Hospital C

• mparison of Attendance by G

ender 1st Nov 2007 - 31st Oct 2008 (64,206 Attendances) Male 34375, 54% Female 29831, 46%

Over one year the split of male to female is 54% Male to 46% Female

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran - C rosshouse Hospital A&E Attendance by G ender & Age G roup - Female 1st Nov 2007 - 31st Oct 2008 (29,831 Attendances) 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000 Age G roup Attendances Female 2902 1394 2341 6921 3614 3095 2789 2720 4055 0 - 5 5 - 10 11 - 16 17 - 35 36 -45 46 - 55 56 - 65 66 - 75 76+

The distribution of age groups showing the large numbers of 17-35’s followed by 76+

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran - C rosshouse Hospital A&E Attendance by G ender & Age G roup - Female 1st Nov 2007 - 31st Oct 2008 (29,831 Attendances) 6.3% 4.2% 4.3% 4.8% 5.6% 4.5% 2.2% 3.6% 10.8% 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000 Age G roup Attendances 0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% Female 2902 1394 2341 6921 3614 3095 2789 2720 4055 P ercentage 4.5% 2.2% 3.6% 10.8% 5.6% 4.8% 4.3% 4.2% 6.3% 0 - 5 5 - 10 11 - 16 17 - 35 36 -45 46 - 55 56 - 65 66 - 75 76+

The 17-35 female group represents 10.8% of the total yearly attendance

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran - C rosshouse Hospital A&E Attendance by G ender & Age G roup 1st Nov 2007 - 31st Oct 2008 (34,375 Attendances) 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000 Age G roup Attendances Male 3805 1738 3250 9462 4552 3623 3085 2529 2331 0 - 5 5 - 10 11 - 16 17 - 35 36 -45 46 - 55 56 - 65 66 - 75 76+

The distribution of age groups showing the large numbers of 17-35 followed by 0-5 The 76+ group much lower than the female figure

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran - C rosshouse Hospital A&E Attendance by G ender & Age G roup - Male 1st Nov 2007 - 31st Oct 2008 (34,375 Attendances) 14.7% 5.1% 2.7% 5.9% 7.1% 5.6% 4.8% 3.9% 3.6% 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000 Age G roup Attendances 0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% 14.0% 16.0% Male 3805 1738 3250 9462 4552 3623 3085 2529 2331 P ercentage 5.9% 2.7% 5.1% 14.7% 7.1% 5.6% 4.8% 3.9% 3.6% 0 - 5 5 - 10 11 - 16 17 - 35 36 -45 46 - 55 56 - 65 66 - 75 76+

The 17-35 male group represents 14.7% of the total yearly attendance

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran - C rosshouse Hospital A&E Attendance by G ender & Age G roup 1st Nov 2007 - 31st Oct 2008 (64,206 Attendances) 1000 2000 3000 4000 5000 6000 7000 8000 9000 10000 Age G roup Attendances Female 2902 1394 2341 6921 3614 3095 2789 2720 4055 Male 3805 1738 3250 9462 4552 3623 3085 2529 2331 0 - 5 5 - 10 11 - 16 17 - 35 36 -45 46 - 55 56 - 65 66 - 75 76+

In comparison the male numbers exceed the female, with the exception of 66+

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran - C rosshouse Hospital A&E Attendance by G ender & Age G roup 1st Nov 2007 - 31st Oct 2008 (64,206 Attendances) 25.5% 8.7% 4.9% 10.4% 12.7% 10.5% 9.1% 8.2% 9.9% 2000 4000 6000 8000 10000 12000 14000 16000 18000 Age G roup Attendances 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% Female 2902 1394 2341 6921 3614 3095 2789 2720 4055 Male 3805 1738 3250 9462 4552 3623 3085 2529 2331 P ercentage 10.4% 4.9% 8.7% 25.5% 12.7% 10.5% 9.1% 8.2% 9.9% 0 - 5 5 - 10 11 - 16 17 - 35 36 -45 46 - 55 56 - 65 66 - 75 76+

The 17-35 group represents 25.5% of the total yearly attendance

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran - C rosshouse Hospital C

• mparison of Attendance by G

ender (17 - 35 YOA) 1st Nov 2007 - 31st Oct 2008 (16,373 Attendances) Male 9452, 58% Female 6921, 42%

Over one year the split of 17-35 male to female is 58% Male to 42% Female

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran - C rosshouse Hospital A&E R eferral S

• urce - Female, 17 -35 YOA

1st Nov 2007 - 31st Oct 2008 (6,921 Attendances) 1000 2000 3000 4000 5000 6000 7000 8000 R eferral S

• urce

Attendances Female 4350 819 753 384 326 58 106 60 54 9 2 S elf 999 G P NHS 24 ADOC P

• lice

Other Other Hospital This Hospital HMP HC P S

• cial

S ervices

The referral sources as expected in a repeatable and known pattern

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran - C rosshouse Hospital A&E R eferral S

• urce - Male, 17 -35 YOA

1st Nov 2007 - 31st Oct 2008 (9,452 Attendances) 1000 2000 3000 4000 5000 6000 7000 8000 R eferral S

• urce

Attendances Male 6858 1217 448 276 193 191 117 67 28 39 12 6 S elf 999 G P NHS 24 ADOC P

• lice

Other Other Hospital This Hospital HMP HC P S

• cial

Services

The same pattern with increased numbers.

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran - C rosshouse Hospital A&E R eferral S

• urce - Both, 17 -35 YOA

1st Nov 2007 - 31st Oct 2008 (16,373 Attendances) 1000 2000 3000 4000 5000 6000 7000 8000 R eferral S

• urce

Attendances Female 4350 819 753 384 326 58 106 60 54 9 2 Male 6858 1217 448 276 193 191 117 67 28 39 12 6 S elf 999 G P NHS 24 ADOC P

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Other Other Hospital This Hospital HMP HC P S

• cial

S ervices

In comparison the Male numbers are higher in Self, 999 & Police referrals – low in other HCP’s referrals e.g. GP, NHS24 & ADOC

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran - C rosshouse Hospital A&E Disposition - Female, 17 -35 YOA 1st Nov 2007 - 31st Oct 2008 (6,921 Attendances) 500 1000 1500 2000 2500 3000 3500 4000 4500 5000 Age G roup 17-35 Attendances

Female 2593 1706 1319 321 321 206 127 71 53 47 86 68 2 1 DNR Admit G P A&E OP ID/LBA Other ADOC Admit Other H Ward as OP Maternity EP AS Died R RT

..again the dispositions also as expected in a repeatable and known pattern

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran - C rosshouse Hospital A&E Disposition - Male, 17 -35 YOA 1st Nov 2007 - 31st Oct 2008 (9,452 Attendances) 500 1000 1500 2000 2500 3000 3500 4000 4500 5000 Age G roup 17-35 Attendances

Male 3646 1650 1816 749 744 439 227 62 59 57 1 2 DNR Admit G P A&E OP ID/LBA Other ADOC Admit Other H Ward as OP Maternity EP AS Died R RT

..a similar pattern with an apparent difference in admissions

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran - C rosshouse Hospital A&E Disposition 17-35 YOA 1st Nov 2007 - 31st Oct 2008 (16,373 Attendances) 500 1000 1500 2000 2500 3000 3500 4000 4500 5000 Disposition Attendances

Female 2593 1706 1319 321 321 206 127 71 53 47 86 68 2 1 Male 3646 1650 1816 749 744 439 227 62 59 57 1 2 DNR Admit G P A&E OP ID/LBA Other ADOC Admit Other H Ward as OP Maternity EP AS Died R RT

In comparison the Male numbers are higher in almost all disposition with exception of admissions …and of course Maternity & Early Pregnancy

23/09/2009

B Samuel 2009

EADT Information Network 11th August 2009

NHS Ayrshire & Arran Crosshouse Hospital A&E Attendance Review

Bryan Samuel: Senior Information Analyst (A&E)

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran - Crosshouse Hospital A&E Attendance Split by Age Group & Gender 1st of January 2008 - 31st of December 2008 (64,803 Attendances)

2000 4000 6000 8000 10000 0-5 6-10 11-16 17-35 36-45 46-55 56-65 66-75 76+ Age Groups Number of Patients Female Male

Starting Point for Analysis Starting Point for Analysis

The male age group 17-35 and the female age group 76+

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran - Crosshouse Hospital A&E Attendance Split by Age Group 1st of January 2008 - 31st of December 2008 (64,803 Attendances)

2000 4000 6000 8000 10000 12000 14000 16000 18000 0-5 6-10 11-16 17-35 36-45 46-55 56-65 66-75 76+ Age Groups Number of Patients

So w hat does the future hold? So w hat does the future hold?

Demand for Tesco style healthcare combined with a demographic time-bomb?

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran - Crosshouse Hospital A&E Attendance Split by Age Group 1999 to 2008 (567,309 Attendances)

2000 4000 6000 8000 10000 12000 14000 16000 18000 0-5 6-10 11-16 17-35 36-45 46-55 56-65 66-75 76+ Age Groups Number of Patients 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

A& E Attendance by Age Group (99-08) A& E Attendance by Age Group (99-08)

No time-bomb but there is increasing attendance by the over 35s Significant increases in 0-5s, 17-35s

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran - Crosshouse Hospital A&E Attendance Split by Patient Age 1st of January 2008 - 31st of December 2008 (64,803 Attendances)

200 400 600 800 1000 1200 1400 1600 1800 6 1 2 1 8 2 4 3 3 6 4 2 4 8 5 4 6 6 6 7 2 7 8 8 4 9 9 6 1 2 Patient Age Number of Patients

So w hat’s going on in detail? So w hat’s going on in detail?

The distribution of A&E patients is fairly complex

23/09/2009

B Samuel 2009 NHS Ayrshire & Arran - Crosshouse Hospital A&E Attendance Split by Patient Age 1999 - 2008 (567,309 Attendances)

200 400 600 800 1000 1200 1400 1600 1800 8 16 24 32 40 48 56 64 72 80 88 96 104 Patient Age Number of Patients 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

From 1999 to 2008 From 1999 to 2008

23/09/2009

B Samuel 2009

The earliest & most recent years only The earliest & most recent years only

NHS Ayrshire & Arran - Crosshouse Hospital A&E Attendance Split by Patient Age 1999, 2000, 2007 & 2008

200 400 600 800 1000 1200 1400 1600 1800 8 16 24 32 40 48 56 64 72 80 88 96 104 Patient Age Number of Patients 1999 2000 2007 2008

Growth in patient numbers almost across the board but particularly in the 0-5 age group

23/09/2009

B Samuel 2009

A& E attendance is grow ing generally! A& E attendance is grow ing generally!

NHS Ayrshire & Arran - Crosshouse Hospital Total A&E Attendance 1999 to 2008 (567,309 Attendances)

50000 52000 54000 56000 58000 60000 62000 64000 66000 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Calendar Year Number of Patients

23/09/2009

B Samuel 2009

Allow ing for general A& E grow th Allow ing for general A& E grow th

NHS Ayrshire & Arran - Crosshouse Hospital A&E Attendance Split by Age Group 1999 to 2008 (567,309 Attendances)

0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 0-5 6-10 11-16 17-35 36-45 46-55 56-65 66-75 76+ Age Groups Percentage of All Patients (%) 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

Most age group growth now flat or decreasing as a proportion of all A&E patients 0-5 group is still on the up!

23/09/2009

B Samuel 2009

Allow ing for A& E Grow th in detail Allow ing for A& E Grow th in detail

NHS Ayrshire & Arran - Crosshouse Hospital A&E Attendance Split by Patient Age 1999 - 2008 (567,309 Attendances)

0.00 0.50 1.00 1.50 2.00 2.50 3.00 8 16 24 32 40 48 56 64 72 80 88 96 104 Patient Age

Percentage of All Patients (%)

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

Most ages seem consistent over time Some notable changes

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran - Crosshouse Hospital A&E Attendance Split by Patient Age 1999, 2000, 2007 & 2008

0.00 0.50 1.00 1.50 2.00 2.50 3.00 8 16 24 32 40 48 56 64 72 80 88 96 104 Patient Age

Percentage of All Patients (%)

1999 2000 2007 2008

The earliest & most recent years only The earliest & most recent years only

The over 40s look proportionally flat! Relative growth in 0-5s, some proportional decay elsewhere below 40

23/09/2009

B Samuel 2009

New Information!

NHS Ayrshire & Arran Ayr Hospital A&E Attendance

23/09/2009

B Samuel 2009

Ayr Hospital is different! Ayr Hospital is different!

NHS Ayrshire & Arran - Ayr Hospital A&E Attendance Split by Age Group 1999 to 2008 (413,672 Attendances)

2000 4000 6000 8000 10000 12000 14000 16000 18000 0-5 6-10 11-16 17-35 36-45 46-55 56-65 66-75 76+ Age Groups Number of Patients 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

< 40 on downward trend! > 40 flat or upward trend!

23/09/2009

B Samuel 2009 NHS Ayrshire & Arran - Ayr Hospital A&E Attendance Split by Patient Age 1999 - 2008 (413,672 Attendances)

100 200 300 400 500 600 700 800 900 8 16 24 32 40 48 56 64 72 80 88 96 104 Patient Age Number of Patients 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

23/09/2009

B Samuel 2009 NHS Ayrshire & Arran - Ayr Hospital A&E Attendance Split by Patient Age 1999, 2000, 2007& 2008

100 200 300 400 500 600 700 800 900 8 16 24 32 40 48 56 64 72 80 88 96 104 Patient Age Number of Patients 1999 2000 2007 2008

Over 40s look flat

• r slightly up

Pronounced decay in patient numbers below 40

23/09/2009

B Samuel 2009

The Ayr Hospital patient trend The Ayr Hospital patient trend

NHS Ayrshire & Arran - Ayr Hospital Total A&E Attendance 1999 to 2008 (413,672 Attendances)

35000 36000 37000 38000 39000 40000 41000 42000 43000 44000 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Calendar Year Number of Patients

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran - Ayr Hospital A&E Attendance Split by Age Group 1999 to 2008 (413,672 Attendances)

0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 0-5 6-10 11-16 17-35 36-45 46-55 56-65 66-75 76+ Age Groups Percentage of All Patients (%) 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

Proportional downward trend in under 40s Over-40s relatively on the up

23/09/2009

B Samuel 2009 NHS Ayrshire & Arran - Ayr Hospital A&E Attendance Split by Patient Age 1999 - 2008 (413,672 Attendances)

0.00 0.50 1.00 1.50 2.00 2.50 8 16 24 32 40 48 56 64 72 80 88 96 104 Patient Age Percentage of All Patients 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

23/09/2009

B Samuel 2009

NHS Ayrshire & Arran - Ayr Hospital A&E Attendance Split by Patient Age 1999, 2000, 2007 & 2008

0.00 0.50 1.00 1.50 2.00 2.50 8 16 24 32 40 48 56 64 72 80 88 96 104 Patient Age Percentage of All Patients 1999 2000 2007 2008

23/09/2009

B Samuel 2009

Summary of observations Summary of observations

• Analysis of Blue/green patients hints

at the inappropriate use of A&E

• Convenience seems to be a factor!

– Contradiction in Heat T10 targets? (reducing attendance Vs widening access)

• It looks like it will be possible to

identify groups of patients than can be redirected

23/09/2009

B Samuel 2009

Some further areas of focus Some further areas of focus

• Will be looking at A&A as a whole:

– This should smooth some local issues

• Presenting complaints & diagnosis
• A closer look at frequent A&E attendees
• The 0-5 & 13-22 groups seem interesting
• Ultimately, whatever we find, we will need

to better understand the driving factors that determine why patients attend A&E; before we can seek to influence behaviour!

23/09/2009

B Samuel 2009

Thank You - any questions?