Imperial College London (ICL)

ID 303

This work could help increase understanding of each of the Trust’s acute admissions profile across seasons and provide insight into factors which have a higher likelihood of contributing to an avoidable admission.

National bed occupancy rates in hospitals are consistently higher than recommended. Lack of available beds causes bottlenecks in the Emergency Department, leading to increased waiting times and suboptimal outcomes for patients needing urgent or emergency care. As such, there is a real need to identify new ways of working so that high acuity patients receive the urgent or emergency care they require in a safe, effective, and timely manner. This research aims to compare hospital admission patterns across the different seasons and regions of the United Kingdom in order to understand instances where admissions to hospital could have been avoided by looking for attendances that would likely have been able to be cared for less urgently. For this, we will use a defined list of codes of ambulatory care sensitive conditions (ACSCs). These are conditions where effective community care and case management can help prevent the need for hospital admission. At the same time, the emergency department often faces much greater pressure in winter, since many health conditions can be worsened by cold weather. By exploring trends across seasons, factors associated with winter pressures on emergency care could be identified helping to anticipate demand at this time of year. This project is part of a national study proposed by the Health Data Research UK (HDR UK), the United Kingdom's national institute for health data science. Each participating site will conduct a local analysis of their data at the hospital site and at the seasonal level. Then the local, anonymised analyses will be combined at a national level. This work could inform service redesign and clinical decision-making at the point of care, towards minimizing delays in emergency and urgent care pathways, increasing the availability of hospital beds for patients who cannot be treated in the community. Research could also help to better understand demand across all seasons to meet patients' needs more effectively and efficiently. We know this project is of interest to the public as its proposal came out of an HDR UK workshop with members of the public from across the UK; the workshop sought to understand public perspectives in making regional, linked health data available for research use, HDR UK invited proposals for projects that would use linked data from different regions across the UK, with the potential for significant impacts for patients and the NHS. HDR UK are planning to hold further patient and public workshops in early Spring 2023. Planned public involvement will include: • Obtaining public perception into a streamlined and harmonised data access and governance approaches to understand what would need to be in place to ensure public trust in these. • Advising on the development of the programme, particularly around information to ease patient concerns about acute admissions.

16/02/2023

TRE