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Welcome to the Emergency Care online newsfeed. Here you’ll find all the latest research, news stories, policy updates and guidelines. View our other newsfeeds for more subject-specific news.

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Statistical releases

NHS England and NHS Digital have released new statistics relevant to emergency care

NHS England  NHS 111 Minimum Data Set (March 2018 data) 

NHS England Ambulance Quality Indicators: Systems Indicators (March 2018 data)

NHS England Ambulance Quality Indicators: Clinical Outcomes (November 2017 data)

NHS England A&E attendances and emergency admissions for March 2018 and Quarterly report (Q4)

 

NHS Digital Provisional Accident and Emergency Quality Indicators for England February 2018, by provider

NHS Digital Provisional Monthly Hospital Episode Statistics for Admitted Patient Care, Outpatients and Accident and Emergency Data – April 2017 to February 2018

Emergency admissions for people in the last year of their life

Marie Curie says that the NHS is struggling to cope with A&E admissions of people who are in the last year of their lives. The charity says the situation will hit crisis point if care provided in the community is not significantly improved.

New data collected by Marie Curie has revealed there were over 1.6 million emergency admissions for people in the last year of their life in Britain in 2016, costing the NHS £2.5 billion and amounting to around 11 million days in hospital.

With an ageing population, the charity predicts the number of people dying each year is going to go up significantly over the next 20 years. This means the cost of emergency admissions for people in the last year of life could almost double.

These admissions could cost the NHS an extra £2 billion, and up to 8,000 extra hospital beds could be needed by 2038 – the equivalent of an extra ward in every hospital with a major A&E unit, dedicated solely to emergency beds for dying people.

Full story : Emergency hospital admissions at the end of life set to sky rocket | Marie Curie

Full briefing: Emergency admissions:  Data briefing | Marie Curie

Violence towards ambulance staff unacceptable and should not be tolerated, says NHS CEO

NHS England  |  March 2018 | NHS boss demands maximum punishment for every violent offence against paramedics

Simon Stevens, chief executive of NHS England has denounced violence against emergency services staff.  Speaking yesterday at the annual Ambulance Leadership Forum in Royal Leamington Spa, he recognised that almost half (47 per cent) of the ambulance workforce say they have been harassed or bullied by members of the public.   Mr. Stevens said that violence or abuse against paramedics,  frontline ambulance crews and control room staff while on duty should not be tolerated (NHS England). 

ambulance-1665303_1920“We need to be frank with the public – it is completely unacceptable that a third of staff say they have been on the receiving end of violence from patients, relatives or the public over the course of the last 12 months. Many ambulance services have a policy of prosecutions when this arises and I want to make sure that this is being brought to the attention of the prosecuting authorities to the maximum degree and NHS England, working together with the ambulance services over the next 12 months, want to monitor the extent to which when these situations arise and ensure the police and the authorities do indeed do what needs to happen. We cannot have a situation where a third of our staff, ambulance staff for goodness sake, are on the receiving end of this kind of behaviour.”

The full unabridged news item can be read at NHS England

Reducing emergency admissions

This report from the National Audit Office examines progress that the Department of Health, NHS England, NHS Improvement and other stakeholders are making in reducing the impact of emergency admissions on acute hospitals.

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The report looks at action across acute, primary, community and social care systems rather than focusing on A&E departments alone. It builds on the 2013 report on Emergency admissions to hospital: managing the demand and our 2016 report on Discharging older patients from hospital, which also examined the pressures on the whole health and social care system.

  • Part One sets out trends in emergency admissions;
  • Part Two explains NHS England’s and partners’ response to increasing emergency admissions;
  • Part Three assesses the challenges in reducing emergency admissions.

Full report: Reducing Emergency Admissions | National Audit Office

Study finds 1 in 4 emergency care staff abused

Lancaster University| 2018 |One in four Emergency staff abused by patients

Researchers at Lancaster University have completed the first ever review into the experience of hospital A&E staff.  They studied the experiences of staff in eight countries. In the UK in 2016 UK, there were over 70,555 total reported assaults on NHS staff. 

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It reveals that the most number of both verbal and physical aggression are in Accident and Emergency departments, with nurses subject to regular verbal and physical abuse.  The staff reviewed as part of the study found it difficult to be both a caregiver and the target of abuse; they also reported feelings of inadequacy and guilt.  Experiencing violence and aggression led to feelings of powerlessness, with some reluctant to work in Emergency Departments. (Lancaster University)

Abstract

Introduction

Patient and visitor violence or aggression against healthcare workers in the Emergency Department (ED) is a significant issue worldwide. This review synthesises existing qualitative studies exploring the first-hand experiences of staff working in the ED to provide insight into preventing this issue.

Method

A meta-ethnographic approach was used to review papers.

Results

Four concepts were identified: ‘The inevitability of violence and aggression’; ‘Staff judgments about why they face violence and aggression’; ‘Managing in isolation’; and ‘Wounded heroes’.

Discussion

Staff resigned themselves to the inevitability of violence and aggression, doing this due to a perceived lack of support from the organisation. Staff made judgements about the reasons for violent incidents which impacted on how they coped and subsequently tolerated the aggressor. Staff often felt isolated when managing violence and aggression. Key recommendations included: Staff training in understanding violence and aggression and clinical supervision.

Conclusion

Violence and aggression in the ED can often be an overwhelming yet inevitable experience for staff. A strong organisational commitment to reducing violence and aggression is imperative.

Full reference:

Ashton, R. A., Morris, L., & Smith, I. |2018 | A qualitative meta-synthesis of emergency department staff experiences of violence and aggression | International emergency nursing |Doi: https://doi.org/10.1016/j.ienj.2017.12.004

The review is available to Rotherham NHS staff to request here

In the media: A&E abuse: Medical staff report more than 70,000 physical and verbal attacks that leave them working in fear

Resources for the ambulance workforce

NHS Employers has developed a range of resources specifically for the ambulance workforce. 

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Image Source: NHS Employers

There are a range of  tools and resources  tailored to the sector which include case studies, examples of good practice and top tips available from the website.

Head First is a digital mental wellness resource design for the ambulance service, it can be accessed here. 

Hidden from the targets: how long are patients waiting for NHS care?

As most of the media attention and national focus in the NHS remains on measuring how many patients are missing the target and wondering when (or if) the NHS can once again hit its targets, we may be losing our focus on how long patients are actually waiting for care.  (King’s Fund blog)

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The full post from Siva Anandaciva chief analyst of the policy at the King’s Fund can be read on the King’s Fund blog here.