As we start moving into the latter stages of the year, I thought it was about time we revisited a topic that we covered last year in our blog – the NHS winter pressures. A lot has happened in the NHS over the last year: the four hour A&E waiting time targets have been missed, key cancer targets for referral to treatment (RFT) have not been hit for over a year and the NHS 111 phone service is missing its target to answer 95% of calls within 60 seconds. The constant however, is the winter pressures faced by the NHS every year.
The NHS faces more pressure over winter than in the other seasons due to the cold and wet weather increasing the likelihood of injuries and illnesses among patients. Among the particularly vulnerable are the old and frail who need more care and attention. This can become an issue for bed occupancy rates across the NHS as they are unable to release patients who need support from community healthcare teams even though they are medically fit to leave the hospital.
Challenges usually confined to the winter period are now being experienced over the course of the year. The four hour A&E target set by the NHS hasn’t been hit nationally for over two years with admission rates rising at consistent rate year on year. It is predicted that by 2022 17,000 further beds will be needed to cope with the demand.
Interestingly, a research report conducted by QualityWatch found that over a quarter of A&E units missed the four hour A&E target despite being less busy than expected. Additionally, there is a decline in the number of A&E attendances over the winter period.
So what is causing these units to miss their targets? Over winter, the proportion of older people admitted to A&E was found to increase and typically they wait longer in A&E than other, younger patients. The older generation of patients typically have more complex and urgent care needs and thus the time it takes to discharge these patients takes a lot longer than others.
The findings in this report illustrate the need for heightened community care for the elderly. This would ensure that they receive a high-level of care outside of hospital, thus freeing up beds for other more critical patients and reducing the strain on A&E departments, particularly during the winter months.
Using data to solve the challenges
Paramount to the success of this approach is the use of data. The NHS has a wealth of data available to it, generated by various departments and areas within the NHS leaving the data siloed. The challenge facing the NHS over recent years has been the ability to integrate this data to gain important insight, so that decision makers are better prepared to make more informed decisions.
By bringing together data across the different areas of the NHS, including primary, community and secondary care, a better picture of patient journey can be formed. Understanding patients’ full medical records is critical and will enable the analysis of their historical medical data in order to identify patterns leading to hospital admissions.
This information can be used in conjunction with predictive analytics to target those patients most at risk of admission and counter-measures can be made to deliver a proactive care plan to these individuals, particularly the elderly.
As technology advances have been made within business intelligence and big data analytics, it seems as though the NHS has not yet caught up and still uses outdated technologies incapable of solving the challenges faced by modern healthcare institutions.
The power of search
We recommend that the NHS leverages search-powered analytics to solve this challenge, allowing access to up-to-date information from all sources in a single user interface without the technical restrictions traditionally associated with legacy technology. With search technology, the NHS can quickly collate their data feeds into speed-optimised, searchable indexes to help measure and understand risk factors leading to admitted patients.
While it is quite apparent that it is difficult to predict A&E admissions over the winter months, it is clear that action can be taken providing the right technologies are employed with the right vision and mentality. Substantial efficiencies and decisions leading to a resolution of the challenges faced by the NHS can be made through a switch an implementation of search-powered analytics.
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