Health Foundation Nuffield Trust, 24 July 2014
- Exploration of the factors thought to be contributing to increased pressure on A&E in the English NHS and tested whether recent changes in these factors could explain the current pressures observed in the system. These factors were capacity, case-mix and external factors (weather / availability of GP services)
- Analysis findings include:
- The average occupancy of England’s A&E units increased by around 8 per cent between 2010/11 and 2012/13.
- Despite large increases in the number of people using A&E services overall, attendances at major A&E units have only increased in line with what would be expected from population growth.
- High occupancy levels are associated with longer average waiting times, and an increased likelihood of breaching the four-hour target. However, high occupancy does not always explain breaches.
- Although A&E departments see more older people than they did previously, this factor appears to only account for around 11 per cent of the observed decline in performance against the four-hour target.
- The winter months in 2012/13 were colder than those in 2011/12, but this appears to explain no more than 19 per cent of the decline in A&E performance over this period.
- No evidence that cases being seen in A&E were becoming more complex in terms of those with multiple LTCs
- No evidence that patient satisfaction with access to their GP is associated with achievement of the four-hour target, but it is related to rates of attendance.
