Our partner organisation, The Strategy Unit (part of the West Midlands and Lancashire Commissioning Support Unit), has published a paper in the Emergency Medicine Journal which looks at changes in the complexity of patients presenting at A&E departments in England.

The most common route to a hospital bed in an emergency is via A&E and many recent initiatives and interventions have the objective of reducing the number of unnecessary emergency admissions.

This new paper assesses whether A&E admission thresholds have changed over time, taking account of the case mix of patients arriving at A&E.

The Emergency Medical Journal article can be found here.

A blog written by Peter Spilsbury, director at the Strategy Unit, on the findings of the research paper – including a copy of the full report – can be found here.

Peter is a nationally recognised expert in the use of economic thinking, analysis and intelligence to support strategic innovation in health and care services and he offers his thoughts on the potential implications of the report for those working in A&E, policy makers and researchers.

The research undertaken by the Strategy Unit sheds some light on the reasons why A&Es are struggling to hit waiting time targets, despite only a modest increase in the number of people using major A&Es and in hospital admissions via A&E.

The findings on case mix and the increased threshold for admission contrast with the stable picture that emerges at first glance and instead suggest big changes in the demands on major A&Es and the ways in which A&E clinicians manage patient care. They also go some way to explain why those working in A&E are feeling under so much pressure.