Friday, 18 July 2014

Research on A&Es - The College of Emergency Medicine

The College of Emergency Medicine

Patron: HRH The Princess Royal
7-9 Bream’s Buildings
Tel +44 (0)207 404 1999
Fax +44 (0)207 067 1267


                                                              22 May 2014

Emergency Departments: More useful than the official data suggests

Only 15% of attendees at Emergency Departments can be seen by a GP in the
community without the need for Emergency Department assessment, according
to new research undertaken by the College.

The findings from research commissioned by the College of Emergency
Medicine and conducted by Candesic found that 85% of patients who visited
A&E were there appropriately and that only one in seven attendees could have
been seen within the community.

The College’s research significantly challenges the often quoted figure that ‘40%
of patients who attend A&E departments are discharged requiring no

The findings of the research arrive at a time when the delivery of Emergency
Medicine faces a severe shortage of Emergency Medicine doctors, an
increasing number of attendances, an unfair payment system to hospitals and a
lack of accessible and effective alternatives to the Emergency Department.

Although the redirection figure of 15% is substantially less than the often quoted
40% it equates to 2.1 million attendances. This reconfirms the College’s call for
the establishment of co-located primary care centres to decongest Emergency

Findings regarding Emergency Department Attendances:

85% of people who visited A&E do so appropriately. Only 15% of
attendees could be seen by a GP in the community without the need for
Emergency Department assessment. The difference between 15% and
40% is stark (around 3.5 million patients per year).

Of the 15% of people who could be seen by a GP the largest sub-group
were young children presenting with symptoms of minor illness.
The group for whom redirection was least probable were the elderly.

- 22% of people could be appropriately managed by a GP working in the
Emergency Department with access to the same resources.

A further 63% attendees within the Emergency Department needed the
skills of a specialist emergency medicine doctor, and 28% were admitted
to hospital.


This data discrepancy should be viewed as an opportunity to design services fit
for the future. The message is clear – A&E Departments should be configured
with access to:

- Primary Care Centres. These should be co-located,
- GP’s to work within the Emergency Department and use the Emergency
   Department facilities,
- Early access to specialist Emergency Medicine doctors.

Dr Clifford Mann, President of the College of Emergency Medicine, said:

“The fact that only 15% of attendees at Emergency Departments could be safely
redirected to a primary care clinician without the need for Emergency
Department assessment is a statistic that must be heeded by those who wish to
reconfigure services.

Providing a more appropriate resource for the 2.1 million patients represented by
this figure would substantially decongest emergency departments.

“Decongesting Emergency Departments is key to relieving the unprecedented
levels of pressure placed upon them and improving patient care. This is one of
the key principles outlined in our call for action: The 10 Priorities to solve the
Emergency Medicine Crisis."

For further information, or to speak with a spokesperson for The College of
Emergency Medicine, please contact +44(0)20 70671275 or email

Notes to editors

This data based analysis on the records of 3,053 patients who visited twelve
Emergency Departments (A&E’s) across the country over a 24 hour period was
collected on Thursday 20th March 2014 by Independent strategy healthcare
consultancy, Candesic. The A&E’s were representative in terms of geography,
age and case mix.

Primary Care Centres

The College recommends locating a Primary Care Centre (also known as an
Urgent Care Centre) alongside the Emergency Department. Primary Care
Centres treat minor injuries and medical problems within a primary care setting.
Patients presenting to the hospital front door can be triaged into either the
Primary Care Centre or the Emergency Department dependent upon their care
needs. This allows for an effective alternative to the Emergency Department and
can support patients in accessing the right care the first time round.

About the College’s 10 priorities the to solve Emergency Medicine Crisis

The College published ’10 priorities for resolving the crisis in Emergency
Departments’ earlier this year and clearly sets out what action needs to be
taken to address the current challenges in A&E. The College through its Members
is playing its part and we are working in 5 key areas.

We have identified 5 priorities for the College and 5 for the Government and
NHS leadership to address the current challenges. Our proposals are the
collective view of practicing Emergency Physicians; they represent cost-
effective solutions to ensure we can deliver safe patient care.

Download 10 priorities for resolving the crisis in Emergency Departments here

About the College of Emergency Medicine
The College of Emergency Medicine is the single authoritative body for
Emergency Medicine in the UK. Emergency Medicine is the medical specialty
which provides doctors and consultants to (Accident &) Emergency
Departments in the NHS in the UK and other healthcare systems across the world.

The College works to ensure high quality care by setting and monitoring
standards of care, and providing expert guidance and advice on policy to
relevant bodies on matters relating to Emergency Medicine.

The College has over 4000 fellows and members, who are doctors and
consultants in Emergency Departments working in the health services in England,
Wales, Scotland and Northern Ireland, Eire and across the world.

                                            Excellence in Emergency Care

Incorporated by Royal Charter, 2008
Registered Charity number 1122689

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