London hospitals have launched a new initiative to better understand why some patients attend A&E so frequently.
“High intensity” users who attend A&E at least six times in as many months include those with mental health problems, alcohol and substance abuse, long term medical conditions, dementia and frailty.
The year-long pilot has launched across eight London boroughs and seven emergency departments, including Ealing Hospital and Northwick Park hospital in Wembley.
NHS bosses have warned that an increasing number of people are presenting to A&E without severe symptoms due to a struggle to access a GP.
As part of the pilot, specialist case workers look into a patient’s medical history and socio-economic situation to see if there are any underlying patterns to their behaviour.
They also liaise with housing and social services, as well as community and voluntary groups, to identify a trigger which may be causing frequent attendances.
Harshal Goswami, a case worker at London North West University Healthcare NHS Trust (LNWH), said she had seen one patient who had attended A&E more than 50 times despite showing no signs of distress or ill health.
“It can be something as simple as loneliness or poor living accommodation and we work with agencies to address that. Sometimes, people aren’t confident enough to self-manage an existing condition like chronic obstructive pulmonary disease (COPD)," he said.
"GPs face the same challenges but have a far more comprehensive picture of a patient’s history in the shape of a Universal Care Plan which we try and get hold of."
She added: "It’s all about cause and effect. If we take a step back and find out why something is happening we can hopefully change the outcome."
The team at LNWH look at up to 25 cases every month.
