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A&E ATTENDANCES – NHS LOTHIAN

A&E ATTENDANCES – NHS LOTHIAN. Sheila King. A&E Departments - Lothian. RIE – approx 105,000 atts per annum St John’s – some 47,000 attendances RHSC (paediatric unit) – 36,000 atts Minor Injuries Unit at Western General Hospital site in north of city – 18,000 patients per annum.

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A&E ATTENDANCES – NHS LOTHIAN

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  1. A&E ATTENDANCES – NHS LOTHIAN Sheila King

  2. A&E Departments - Lothian • RIE – approx 105,000 atts per annum • St John’s – some 47,000 attendances • RHSC (paediatric unit) – 36,000 atts • Minor Injuries Unit at Western General Hospital site in north of city – 18,000 patients per annum

  3. Trends in attendance – November to June • November 08 to June 09 compared to Nov 07 to June 08 • RIE A&E up 3% • St John’s up 9% • RHSC up over 8% • WGH MIU only increased by 1% • Proceed to analyse 3 main sites over 4 months March to June 2009

  4. Referral source by site

  5. Triage Category

  6. Arrival Mode

  7. % age band – all 3 sites

  8. % age admitted from A&E

  9. % admitted by age band

  10. % age by arrival hour by site

  11. % age discharges to “GP care – no further appointment”

  12. Did Not Waits • RIE and St John’s – a total of 1236 patients left without being seen in 4 months • 736 (62%) left within 2 hours of arrival • 25% of did not waits arrived by emergency ambulance • 50% were in the age group 15 to 34

  13. Conclusion • 3 very different A&E departments • Disproportionate usage of A&E greatest among 0-4, 5-14, 15-24 and over 75 year olds • Admission from A&E increases markedly with age • Attendances by arrival hour – very obvious peak 6-7pm RHSC, 6pm St John’s, late morning RIE • Surprising issues around “did not waits”, many leaving within 2 hours, 25% arriving by emergency ambulance • Proceed to look to try to find some pointers around increased activity, particularly evident on RHSCand St John’s sites

  14. RHSC – March to June 09 vs March to June 08 • 7% increase in A&E attendances • Large increases in 999 emergency and GP sources of referral • Age band 0-4 increased attendances by 27% (rising birth rate but disproportionately high increase in A&E att) – all other age bands reduced • Admissions from A&E down – both %age admission rate and overall number of admissions (despite 7% increase in A&E attendance

  15. St John’s – March to June 09 vs March to June 08 • 5.5% increase in A&E attendances • Age band 0-4 increased attendance by 27%, 5-14 increased by 10% • Over 55% of increase accounted for by 0-14 year olds at St John’s A&E • Admissions from A&E down – both %age admission rate and overall number of admissions (despite increase in A&E attendance) • Admission rates down by 17% in 0-14 age group and by 15% in 15-24 year old age group

  16. RIE – March to June 09 vs March to June 08 • 3.7% increase in A&E attendances • 55% increase in 5-14 year old age group, 8% increase in 15-24 age group and 7% in 65-74 age group • Admission rate from A&E down v. slightly from 28.9% to 28.2% (in total number of admissions up 1.4%) • Increase in number of admissions accounted for mainly by 65-74 age group, but also 15-24 age group.

  17. CONCLUSION • A&E attendance rates increasing in all 3 A&E departments (based on 4 months 2008/2009) • Younger age groups large contributor to increased attendances • Admission rates from A&E down on all 3 sites – RHSC and St John’s – number of admissions down despite increased A&E attendance • RIE site – 65-74 age group accounts for 70% of increase in admissions (but only 14% of increase in attendances)

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