A&E visits hit record high

Rise in older people needing care has contributed to increase in hospital emergency visits to around 24 million a year

The number of patients going to accident and emergency departments has hit an all-time high, driven by a big rise in the number of older people needing care, NHS statistics have revealed.

Total attendances at hospital A&E units in England have climbed every year for the past eight years, from 17.837m in 2004-05 to 21.739m in the first 11 months of 2012-13 – a rise of 21.9%. However, attendances during March 2013 are likely to add another 2 million to the 2012-13 total, pushing the total attendances last year to around 24m.

Figures released by the NHS's Health and Social Care Information Centre (HSCIC) depict a relentless rise in A&E attendances, but with a notably large jump occurring between 2011-12 (21.481m) and 2012-13 (21.739m after 11 months). The figures cast serious doubt on health secretary Jeremy Hunt's recent claims that the rise in A&E attendances was due to Labour's "historic mistake" in 2004 of letting GPs no longer be responsible for providing out-of-hours care.

The ageing population, and the fact that growing numbers of older people are suffering from one or more long-term illnesses, such as diabetes and breathing problems, are key factors in the ongoing surge.

HSCIC data for the past five years shows that the number of people aged 60-79 attending A&E has risen from 1.729m in 2007-08 to 2.505m in the first 11 months of 2012-13, with a similarly steep increase among those aged at least 80 from 913,785 in 2007-08 to 1.408m in most of 2012-13.

The growing crisis in A&E has made headlines in recent months as medical organisations have voiced concern about what they say is an unsustainable rise in attendances and admissions. The College of Emergency Medicine (CEM), which represents A&E doctors, claims emergency departments are now under such pressure that they have become "like warzones".

The Department of Health responded to the new data by acknowledging the increasing pressures on A&E departments.

"There have been more than 1 million extra people visiting A&E over the last three years. Patients should expect a high-quality and timely service, and since the end of April over 95% of patients have been seen within four hours, as they were before last winter," a spokesman said.

"We know that emergency care services need to change to ensure people have access to the best care when they need it. That is why we have already asked NHS medical director Professor Sir Bruce Keogh to lead a review of urgent and emergency care looking at the demand and how the NHS can respond.

"We are looking at how we improve the health service to address the needs of older people, as over-70s account for 35% of emergency admissions. If the health service was better geared towards prevention for this age group we could reduce the pressure on A&E departments," he said.

The CEM has said that many A&E units are understaffed, with a particular shortage of consultants. But the HSCIC's figures also show that the number of doctors working in emergency departments in England increased by 71% over the past decade, from 3,183 in 2002 to 5,437 in 2012.


Denis Campbell, health correspondent

The GuardianTramp

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