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Timely admissions

  • Last modified date:
    8 February 2007

Every year, around 10.9 million patients attend major A&E departments in England. Of these 2.3 million, or 20 per cent, go on to be admitted as emergencies via A&E. Currently 55 per cent of patients who are admitted as emergencies spend over four hours in A&E from arrival.

The timely admissions workstream is focusing on reducing the length of time a patient spends in A&E waiting for a bed once the decision to admit them has been taken.

Key target

  • By December 2004 all patients requiring emergency admission via A&E are admitted to a bed in the hospital within four hours of arrival at A&E.

Work in progress

Reducing delays to admission from A&E is critical to achieving the national four-hour target. Waits for beds come after potentially lengthy waits for assessment and treatment before the decision to admit the patient is made. These patients are the group at highest risk of very long (over 8 hour) waits in A&E and therefore very poor patient experience.  Cutting waits for these patients will mean significant changes to the way hospitals operate.

It will mean:

  • Working with the Modernisation Agency through the Emergency Care Collaborative in promoting speedier admission including improved admission processes.
  • Supporting the NHS in profiling admission and discharges for emergency and elective patients to produce minimum queues in A&E.
  • Supporting the NHS in making appropriate use of total acute capacity.

Future thinking

Working with trusts and the Modernisation Agency, the Department of Health is currently exploring how it can practically support trusts in achieving shorter waits for beds once admitted. Some of the areas being looked at are maximising bed availability through more rigorous scheduling of admissions and discharges and helping trusts identify if a their total acute capacity is sufficient to allow timely admission of emergency patients.

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