Trends in emergency admissions in England 2004 – 2009: is greater efficiency breeding inefficiency?

Author: Ian Blunt, Martin Bardsley & Jennifer Dixon

Publisher: Nuffield Trust

Approximately 35 per cent of all admissions in the NHS in England are classified as emergency admissions, costing approximately £11 billion a year. Admitting a patient to hospital as an emergency case is costly and frequently preventable, yet the number of emergency admissions to hospital has been rising for some time. There has also been a rise in the use of other healthcare services such as attendance in A&E departments and consultations in general practice.

This briefing paper examines the rise in emergency hospital admissions in England from 2004/05 to 2008/09 and tries to identify the possible explanations.

The report examines a number of possible reasons for the rise, including the impact of targets, the ageing population, and variations across different hospitals. It concludes that the rise has, in part, been caused by a lowering of the clinical threshold for emergency admissions – advances in medical care and management have reduced the length of time patients stay in hospital, which in turn has freed up more available beds and allowed doctors to admit more patients. To break out of this cycle in future will mean creating better out-of hospital care and preventive care to reduce the risk to patients of admission and enable expensive hospital beds to be closed, the report argues.

This briefing will be of interest to healthcare policy-makers, senior managers and clinicians, and others interested in efficiency, as well as academics and students in the fields of healthcare and social policy.

The briefing is accompanied by a more in-depth report: Trends in emergency admissions in England 2004 – 2009, by Ian Blunt, Martin Bardsley and Jennifer Dixon. The full report is available to download here.


Click here to access our range of resources from the ‘Understanding trends in emergency care’ project.


Price: £5.00

Date: 05/07/2010

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