A new report has found that the number of babies and young children admitted to hospital in an emergency has grown by almost a third over the past decade, and many children are being admitted to hospital for conditions like asthma and tonsillitis – admissions that could potentially have been avoided with better care and support out of hospital.
Children and young people are frequent users of emergency services. While not all emergency hospital admissions can be prevented, our research found that, despite some improvements, many children are still treated in an emergency setting for chronic conditions such as asthma.Eilís Keeble, lead author and Research Analyst at the Nuffield Trust
The findings come in a new study from the Nuffield Trust and Health Foundation, which draws on in-depth analysis of hundreds of thousands of patient records to explore how children and young people have been accessing emergency hospital care over the decade from 2006/07 to 2015/16.
It finds that emergency hospital admissions for the under 25s have grown by 14% over the time period – less than the population as a whole - but that the very youngest children experienced a disproportionate rise in emergency admissions, with babies experiencing a 30% rise over the decade. The authors say the reasons behind this are complex and more research is needed to understand these figures, but that they raise questions about the quality of maternity and community services.
While hospital is usually the right place for children and young people with serious urgent care needs, our study suggests that a proportion of these admissions could have been prevented by improving access to high quality paediatric or child health care closer to people’s homes.Lucia Kossarova, Senior Research Analyst at the Nuffield Trust
The study also reveals that some of the emergency admissions in the under 25s in 2015/16 could have been potentially prevented if conditions like asthma or acute tonsillitis were better managed in a non-emergency care setting. The authors say these findings raise questions about where children and young people can access high quality treatment outside of the hospital emergency care setting.
Key findings include:
- The number of emergency hospital admissions for the under 25s grew from 990,903 in 2006/07 to 1,124,863 in 2015/16 – a rise of 14%. This compares to a 20% rise in emergency admissions for the population as a whole.
- Babies (under one year old) and children under 4 years of age experienced the biggest rise in admissions, with the numbers of emergency admissions growing by 30% and 28% respectively between 2006/7 to 2015/16.
- The number of babies admitted in an emergency for jaundice more than doubled over the time period, from 8,186 cases in 2006/07 to 16,491 cases in 2015/16.
- The numbers of children and young people under the age of 25 admitted for viral infections more than doubled between 2006/07 and 2015/16, from 42,243 to 91,386 cases.
- Children and young people admitted for acute and chronic tonsillitis – of which a proportion were potentially preventable - rose by 68% over the same period, to 37,549.
- There has been a decline in the rate of in-hospital mortality following emergency admissions, from one death per 1,274 admissions in 2006/07 to one death per 1,923 admissions in 2015/16.
The research also finds that the average time children and young people spend in hospital after an emergency admission has reduced by almost a fifth over the time period, which is partly related to a rise in short-stay emergency admissions, which increased by 20%.
Commenting on the research, Lucia Kossarova, senior research analyst at the Nuffield Trust, said:
“As the NHS emerges from its toughest winter yet, much of the focus– perhaps understandably – has been on how hospitals have been coping with the rising numbers of older people needing emergency care. But this research reveals that many of the youngest members of society use emergency care in large and increasing numbers.
“While hospital is usually the right place for children and young people with serious urgent care needs, our study suggests that a proportion of these admissions could have been prevented by improving access to high quality paediatric or child health care closer to people’s homes. There are many new initiatives around the country that provide possible solutions for how hospital emergency admissions for children and young people could be reduced.”
Commenting on the research, Eilís Keeble, lead author and research analyst at the Nuffield Trust, said:
“Children and young people are frequent users of emergency services. While not all emergency hospital admissions can be prevented, our research found that, despite some improvements, many children are still treated in an emergency setting for chronic conditions such as asthma.
This study provides a useful insight into areas where demand for hospital services could be reduced if more appropriate care and support is provided to children and young people early on.”
Notes to editors
- The above figures have not been adjusted for population change. For population adjusted figures, please see the full report.
- The full QualityWatch report, ‘Focus on: Emergency hospital care for children and young people’ by Eilís Keeble and Lucia Kossarova is available to download from www.qualitywatch.org.uk/cyp, along with a research summary.
- QualityWatch is a joint programme by the Nuffield Trust and Health Foundation providing independent scrutiny of health and social care quality data. The programme monitors over 300 care quality indicators, which are published on the QualityWatch website. It also publishes research reports, news and blogs about care quality and data. www.qualitywatch.org.uk