Our A&E Service needs to understand where health and access inequalities exist and how pathways could be streamlined to improve capacity, patient flow and experience. Otherwise patients may be adversely affected by demographic factors without the service realising, and operational pressures arising from increasing post-Covid demand could severely impact service capability.
How can we support a service to explore, highlight and address the challenges of ‘health inequalities’ that feature so prominently within the NHS Long Term Plan, and prepare it for increasing ‘post-Covid’ levels of demand?
- The creation of our A&E Demographics Analyser.
- A greater awareness of electronic data sets that exist within a clinical area. Not only does this allow us to improve our Patient Level Costing System (PLICS) outputs for this service, it has also improved our capabilities when supporting other clinical engagement projects.
- Finally, for any Costing Team, growing clinical engagement with our outputs always a challenge. This collaboration has raised awareness of what we can do within our A&E Service to support them in providing the best possible care for our patients.
Numerous benefits including that our A&E Service now has a better understanding of · the demographics of the patients they treat · any inequalities that might exist due to age, race, gender or deprivation. · The numbers of patients admitted for less than a day following their A&E attendance, and if they could have been better served within an ambulatory setting, or · which pathways could benefit from the development of a Same Day Emergency Care (SDEC) facility to prevent patients being admitted to beds unnecessarily. The exposure the tool has received from showing it to external health partners has also highlighted the possibilities and benefits of ‘system-wide’ collaboration. For example, following a demo to our regional ambulance service, they were keen to understand the numbers of patients they brought to A&E that required no treatments or investigations. Creating alternative pathways for these patients could potentially reduce the demands on our hospital resources.