NHS England treats too many patients as an emergency, watchdog warns

Hospitals in England are admitting so many patients as medical emergencies that the NHS’s finances and ability to function are under threat, Whitehall’s spending watchdog has warned.

But one in four of the growing number of mainly older people who end up in inpatient care should not be in hospital in the first place, according to the National Audit Office (NAO).

The ageing population and other unexplained factors mean hospitals are now treating 5.8 million patients as emergency admissions every year, 24% more than a decade ago, the NAO found. Together they cost the health service £13.7bn, almost a 10th of its budget, and account for 33.59m bed days.

Its hard-hitting report, published on Friday, praises NHS England’s handling of the extra numbers but also criticises its failure to put in place enough services outside of hospitals to keep patients healthier.

The watchdog believes this lack of provision underpins its finding that 24% of emergency admissions are avoidable, implying that £3.43bn a year of NHS funds may be being wasted on people who, with better care, would not have ended up falling ill.

The NAO said: “The impact on hospitals of rising emergency admissions poses a serious challenge to both the service and financial position of the NHS.”

It acknowledged that hospitals have done well to reduce the overall impact of rising emergency admissions in recent years, in particular by reducing patients’ length of stay and treating more patients as day cases.

But it warned: “[The health service] cannot know if its approach is achieving enduring results until it understands whether reported increases in readmissions are a sign that some people admitted as an emergency are being discharged too soon.

“The NHS also still has too many avoidable admissions and too much unexplained variation. A lot of effort is being made and progress can be seen in some areas, but the challenge of managing emergency admissions is far from being under control.”