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Coming next week…

Don't miss the 2019 edition of "Patient Experience in England", due out next week.
Our annual "state of patient experience" overview picks out highlights and insights from wide-ranging evidence published over the last twelve months.

This year's edition will explain how some patients are more equal than others; it will look at how online feedback can build community; and it will show that, as public funding for patient voice drops, the drug companies are moving in.

The report will be published next Tuesday 10th September.  Look out for it on the Patient Experience Library website:

Emergency admissions from care homes

It is well-known that one of the pressures on hospitals is delayed discharge - often linked to lack of capacity in care services.  However, the care system can also cause pressure at the front end, by referring people into hospital unnecessarily.  And A&E departments can take the brunt of this.

This Health Foundation briefing starts by observing that emergency admissions from care homes can expose residents to stress, loss of independence and risk of infection. It says that care home residents often prefer to be treated in the care home - so reducing emergency admissions could be good for residents, as well as help reduce pressure on the NHS. 

The numbers are large - in 2016/17, over a quarter of a million care home residents in England attended A&E.  But 41% of emergency admissions from care homes were for conditions that were potentially manageable outside a hospital setting, or that could have been caused by poor care or neglect.

The authors were surprised to find that emergency admissions were particularly high from residential care homes as against nursing care homes.  Given that residential care homes provide 24- hour personal care, they say, one might expect residential care home residents to be less seriously ill than nursing home residents.

The study looked at four initiatives to improve health and care in care homes that were associated with the NHS’s New Care Models programme.  It found reductions in at least some measures of emergency hospital use for residents who received enhanced support.  This, it says, shows that there is potential to reduce demand for emergency care from care homes, but it also points to implementation challenges.

Co-production between health care professionals and care homes is key to tackling these challenges - but so is access to linked administrative datasets that can provide evidence to support policy making.  It is important, say the authors, that these sorts of data are routinely and consistently collected and are easily accessible if we are to understand residents’ health care needs and improve care for this vulnerable group.

You can download the report via our website.
A&E evidence on tap

There is plenty of evidence available on people's experiences of A&E services, and pointers to how improvements might be achieved.

This American study found that emergency departments (EDs) focus on rapid triage and diagnosis of the acute issue, rather than addressing older patients' underlying issues such as multi-morbidity and polypharmacy. It looks at the aspects of health-related quality of life that are most valued by geriatric patients with a recent ED encounter.

This study looks at "appropriate" use of A&E services.  It finds that  people are required, often at the point when sick or injured, to distinguish between services  categorised as “routine,” “urgent,” “emergency,” “primary” or “acute” and to which access may vary according to time of day, and day of week. This can make it difficult to "choose wisely".

Part of NHS England's 'Integrated care in action' series of briefings, this note looks at how integrated care systems are changing urgent and emergency care services. It covers health care hubs, first responders and early intervention, and offers case studies of how integrated care services are responding.
For more on patient experience in A&E services, search "A&E" here:  
This just in…
Free resources

Not a subscriber to the Patient Experience Library?  Don't worry - you can still get lots of free stuff from our website!  

Our quarterly Patient Experience magazine carries insightful comment from a range of contributors, as well as our top picks of recent reports on patient experience and patient/public involvement. 

Patient Experience in England is our annual overview of the evidence base, drawing on surveys and research from government bodies, health charities and academic institutions.  The evidence is broken down into manageable chunks, and research findings are grouped under key themes for ease of understanding. 

You can browse our Knowledge Maps to see how patient experience is being reported in your area.  

And if you want to wear your patient experience heart on your sleeve, you can download and print our posters and stick them on your wall.  Better still, post them to the Chief Executive of your local NHS Trust!
Do you know of a stand-out report on patient experience that people in CCG's, PALS teams and local Healthwatch should be reading?  If you do, and you'd like to see it featured in this newsletter, let us know! 
The Patient Experience Library offers unparalleled access to patient insight and experience with over 50,000 documents, including...
  • Patient experience reports from health and care charities and think tanks
  • Guidance on matters such as patient-centred commissioning
  • CQC inspection reports and patient survey results
  • All the reports from the local Healthwatch network
  • Quality Accounts from health service providers
  • Valuable archive materials from bodies such as LINk and the NHS Institute
For details of free services, pay as you go services and subscriptions, click here.
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