Since the winter, the issue of pressure on A&E and emergency hospital admissions has been centre stage in the media and in political debate. While the Conservatives claim that the NHS is safe in their hands, Labour argue that the health service is in crisis. Certainly, the NHS is under intense pressure and, in many areas, has been struggling to meet waiting time targets – but we need to take a step back from current controversies and place these issues in a broader context.
First, public satisfaction with the NHS remains high and most people are arguably still seen in a timely way - while the four hour A&E target is a helpful indication of pressure on the system as a whole, it might not be such a good measure of individual organisational performance and perhaps is not the 'be all and end all' it is sometimes claimed to be.
Second, many current accounts focus on a particular issue (whether it's access to GP appointments, cuts to social budgets or out of hours care etc) without seeing things in the round. Often, individual services only get to see the patient when they come in through the front door, and so can only comment on whether an admission is needed at that specific moment in time. In contrast, it is usually only the older person and their family who have a sense of how their health has changed over time, what help they sought, what happened next and how a crisis subsequently led to an admission. In response, the University of Birmingham is conducting national research with older people and their families trying to explore their experience of emergency admission and using their expertise to develop new approaches.
Overall, we believe that part of the problem is that emergency hospital admissions occur for diverse and complex reasons - and that different people often have different views as to the nature of the problem and the best course of action. In response, this study seeks to draw on multiple methods of exploring emergency admissions and on different perspectives from research, from practice and from the lived experience older people and their families. This is crucial if an issue as multi-faceted as emergency admissions is to be fully understood in the round and - where appropriate - reduced.