Emergency admissions in young children rise a third in 10 years

GP workforce problems have contributed to growing levels of emergency hospital admissions for children with asthma, tonsillitis and epilepsy, researchers have warned.

Emergency admissions have risen by a third (30%) for babies under one year old over the last 10 years, and 28% for children under four, researchers have said.

Accounting for young people as a whole, defined as under 25s, emergency admissions have increased 14%, rising from 99,000 to over 1,100,000 in the decade preceding 2016/17.

The QualityWatch research programme, developed by the Nuffield Trust and Health Foundation, drew on hundreds of thousands of patient records to assess how children and young people accessed emergency hospital care from 2006/07 to 2016/17.

It warned that admissions arising from three of the 10 most common conditions for doing so – asthma, epilepsy and acute tonsillitis – could have been avoided ‘with better care and support outside of hospital’. Admissions due to tonsillitis rose the most, climbing 68%.

Emergency admissions

The trend ‘raises questions’ about the quality of community services, it added, suggesting that lack of capacity, accessibility and paediatric expertise of general practitioners may be contributing to the rise.

It comes as the number of people attending A&E sits at ‘an all-time high’. Targets for 95% of patients to be seen within the first four hours have not been met since July 2013.

Eilís Keeble, lead author and research analyst at the Nuffield Trust, said: ‘While not all emergency hospital admissions can be prevented, our research found that, despite some improvements, many children are still treated in an emergency setting for chronic conditions such as asthma.

‘This study provides a useful insight into areas where demand for hospital services could be reduced if more appropriate care and support is provided to children and young people early on.’

Lucia Kossarova, senior research analyst at the Nuffield Trust, said: ‘While hospital is usually the right place for children and young people with serious urgent care needs, our study suggests that a proportion of these admissions could have been prevented by improving access to high quality paediatric or child health care closer to people’s homes.’

GP capacity

GPC deputy chairman Dr Richard Vautrey said: ‘I think one of the issues is the risk aversion of clinicians within hospital settings when patients present in hospital. Particularly when children first present, they might be monitored in hospital just for one night.

‘While many of those may be appropriate, it can potentially be reduced if there was greater capacity within general practice so they present there instead of A&E.

‘But the real challenge is how we expand the appointment availability – within the daytime, but also crucially in out-of-hours. One of the hidden, critical issues over recent years has been the underfunding of out-of-hours, and yet we don’t see the priority of investment into out-of-hours.’

Photo: iStock

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