Health inequalities and deprivation 'key factors' behind repeat A&E visits in Dorset

Strictly embargoed until 00:01 hours Monday 25 November 2024

A new report from the British Red Cross, Seen and heard: Understanding frequent attendance at A&E, has found people who frequently attended A&E in Dorset were 72 per cent more likely to live in an area of deprivation [1].  

Other common issues included mental ill health and multiple long-term health conditions. Many of those frequently attending A&E had often tried to get other help, but this had not met their needs. This meant that when they reached A&E, they were often in need of more urgent care.   

The British Red Cross, which supports people who frequently attend A&E, collaborated with the Dorset Integrated Care Board to review data from a five-year period to understand who needed to make repeat A&E visits in the Dorset area, and why [2]. The charity says understanding this could help NHS Trusts and Integrated Care Systems nationally take action to better support people and reduce pressure on A&E departments. The research is published ahead of winter, typically a period when A&Es see additional pressure. 

The research found almost one in seven A&E attendances in Dorset were from a small group of people, who were less the two per cent of the county’s population. Compared with Dorset’s general population, they were more likely to arrive by ambulance, be classed as urgent cases or need hospital admission.  

The majority of people attending A&E frequently fell into two main groups: people over 70, most of who had multiple long-term conditions; and people aged 20-49, particularly younger women, with mental ill health.  

Across the country, many people are making repeat visits to A&E due to unresolved medical issues and other unmet non-clinical needs. The charity is calling for more dedicated high intensity use of A&E (HIU) services and improved access to community care services to support people before they reach crisis point. The charity also says that action is needed to address health inequalities and to develop proactive care for people with long-term conditions that considers the whole person, including deprivation and other factors which could impact their health. 

Béatrice Butsana-Sita, British Red Cross chief executive, said:  

“Every year millions of people go to A&E when they have an accident or are in desperate need of care. But some people have to attend more than others. There are many reasons that can contribute to this and for those individuals, it is very distressing. It is a situation any of us could find ourselves in. 

“We must strive to understand what people are experiencing if they often go to A&E and why. Our research looked into this and found almost one in seven A&E attendances in Dorset were from less than 2 per cent of the county’s population. Those people needed help and were far more likely to be classed as urgent cases or need hospital admission. 

“Our Red Cross teams work with the NHS across the country and regularly see people facing a range of issues, from isolation to inadequate housing and other challenges that impact health and wellbeing. As the government embarks on the development of a new plan to transform the NHS, this research provides further urgency for the need to tackle underlying causes of ill health, resource vital community services and more dedicated high intensity use of A&E services. This will help make sure the right services are in place to support people with compassion when they need it most before they reach crisis point.” 

British Red Cross runs a HIU service in Dorset working with people who frequently attend A&E. The project works with A&Es at Bournemouth and Poole hospitals, and has helped 50 people in the past year [3].  

Laurence, 52, has been supported by the British Red Cross Dorset HIU Service for seven months after going to A&E multiple times due to severe nerve pain between September 2023 and March 2024. He is now being helped by a pain management clinic and other interventions, has been able to return to work and not needed to visit A&E since March this year.  

Laurence said: 

“I went to the GP maybe 10 times with the same problem, pretty much day after day. I was crying my eyes out I was in so much pain, I’m in my 50s and I don’t do that do sort of thing. I wasn’t getting answers and that’s what made me go to the A&E, because I was so much pain. At times it was horrific. I couldn’t sit, walk or lie down. Several times I was just pushed away because no-one knew what I was going through as I was getting pain in different areas. It was like bashing my head against a brick wall, I didn’t know where to go. The Red Cross HIU service has given me a lot of confidence with work. [Before] I didn’t have my head into anything. I couldn’t concentrate, I couldn’t do anything. I think without the service I would have been a wreck. I’m 100 per cent coming back to myself.” 

Becky Whale, Deputy Director Urgent and Emergency Care and Flow at NHS Dorset ICB said: 

“This report on frequent attenders to Emergency Departments (ED) highlights a critical issue that impacts both patients and healthcare systems. It's important to recognise the challenges faced by these individuals, who often deal with complex health and social issues. 

“By addressing the underlying social determinants of health, we can help frequent attenders achieve better overall well-being and reduce their reliance on emergency services. This approach not only benefits the patients but also alleviates the strain on our healthcare system, allowing resources to be used more effectively. 

“It's encouraging to see such focused efforts to improve care for those who need it most. Together, we can continue to make strides in providing compassionate and effective support for frequent ED attenders.” 

 

ENDS  

Notes to editors 

[1] Seen and heard: Understanding frequent attendance at A&E, British Red Cross, November 2024 

[2] For this research, frequent attendance or high intensity use (HIU) of A&E is defined as the same individual attending A&E five times or more in a rolling 12-month period.  

[3] The British Red Cross High Intensity Use (HIU) Programme helps people who frequently attend A&E and other health services. The Red Cross HIU service in Dorset began in 2022. We work in all seven English NHS regions providing services to help reduce HIU use of A&E and last year we worked with 1,700 people across more than 40 services. 

About the British Red Cross

British Red Cross has over 75 years’ experience working with the NHS and with community care. Our services for people in the UK are designed to help people most in need, including supporting people after a hospital stay. For more information go to www.redcross.org.uk/get-help and to see our previous health reports go to research and publications | British Red Cross .

For over 150 years, the British Red Cross has helped people in crisis, whoever and wherever they are. With millions of volunteers in over 190 countries, the British Red Cross is part of an international humanitarian Movement that’s there for people before, during and after a crisis. Together, we are the world’s emergency responders. 

Further information

For further information, please contact us on 020 7877 7557 or press@redcross.org.uk