University research helps Sheffield Children's A&E plan for rise in demand

Research by Sheffield Hallam University shows that more than a fifth of those arriving at Sheffield Children's Hospital's A&E don't need emergency care

Sheffield Hallam University has worked with Sheffield Children's Hospital's A&E to simulate scenarios to cope with demand at peak hours within the department. Research by the University found that while the number of annual visitors to A&E is set to rise past 50,000 per year for the first time, nearly a quarter (22%) of those who arrive at the department don't need emergency care.

Working with NHS Sheffield Clinical Commissioning Group (CCG), the research team from the University used computer simulation models to identify the best configuration for the Children's Hospital's A&E department. At the moment, when patients arrive at A&E they are assessed by a triage nurse, whose job is to prioritise patients who need urgent attention, whether in quiet or peak times.

'Sheffield Children's Hospital is one of the leading medical facilities for children in the country and therefore we are always looking at ways of improving patient care and experience,' said Dr Margaret Ainger, Clinical Director for Children, Young People and Maternity Portfolio at NHS Sheffield CCG, who commissioned the report. 'The research by Sheffield Hallam University has found some interesting trends with regards to our A&E department and we will be reviewing the findings to help to further benefit our patients.

'The number of A&E arrivals is set to go beyond 50,000 next year and it is therefore vitally important that we have the best processes in place to ensure that patients are treated and assessed appropriately to put them and their families at ease.'

Professor Terrence Perera, an expert on computer simulation at Hallam University, who led the research, said: 'The four researchers were all part of the Science without Borders programme from Brazil, using their skills with simulation and data analysis to look at the A&E department at the Children's Hospital.

'Using simulations minimises the risks involved in change management projects and gives an insight into what to expect before changes are implemented in real world. This means that the hospital can gain an idea of what effect changes will have and the best course of action to take.'

The collaboration comes at a time when A&E services are under increasing pressure. A recent report by the charity Carers UK identified serious difficulties accessing primary and community support services, with 1 in 5 carers saying they had no option but to take their loved one to A&E because it was impossible to see a district nurse or a GP out of hours, and 1 in 10 saying they didn’t know where else to go.

The report, Pressure points: carers and the NHS, found that the majority of carers who have taken their loved one to A&E in the past 12 months believe their admission could have been prevented with more (55%) or higher quality support (50%) for the person they care for, more local support for them as a carer (32%) or access to a district nurse (25%).

There were more than 500,000 more visits to A&E in the first quarter of 2016 than the same period last year. This growing demand on the NHS is forcing many people to be discharged from hospital too early, often without the right support in place at home and without proper consultation with their family.

Over half of carers (58%) said that the person they care for had been discharged from hospital too early; with 12% saying their loved one had to be readmitted at a result. Not only is this counterproductive for the health of the person being cared for but it also causes undue stress and anxiety for families and friends who are often unprepared to take on caring responsibilities or coordinate aftercare themselves.

'With more and more families picking up caring responsibilities and older people with care needs being encouraged to stay at home for longer, a step-change is urgently needed to boost investment in community services and involve carers in decisions about the support they, and their loved ones, need to manage at home,' said Heléna Herklots, Chief Executive of Carers UK.

'The majority of care provided in England is not by doctors, nurses or care workers, but by family and friends. These carers have told us that they aren’t able access the support they need, when they need it, from community health and care services, so they are reluctantly having to turn to A&E.'

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