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divdiv class=story-body readability=39 span class=story-date#13; span class=date30 October 2013/span#13;span class=time-textLast updated at /spanspan class=time20:02 ET/span#13; #13;/span#13;#13; #13;#13;#13; #13; #13; span class=byline span class=byline-nameBy Adam Brimelow/span span class=byline-titleHealth Correspondent, BBC News/span /span #13; #13; p class=introduction id=story_continues_1There are too many emergency admissions to hospitals in England, according to the government spending watchdog. /p#13; pThe National Audit Office says there were 5.3m such admissions in the last financial year - a 47% rise in 15 years - and many of these patients stay in hospital for longer than necessary./p#13; pIt says it is critical the NHS does better in dealing with these problems to cope with rising winter pressures. /p#13; pNHS England says big decisions are needed to develop alternatives./p#13; span class=cross-head'Default route'/span#13; pThe NAO report looks at how well emergency admissions to hospital are managed. These are admissions that are not planned, and happen at short notice because of the perceived clinical need./p#13; pThe report points out that, although admissions per head of population are lower in England than in Scotland and Wales, the rate of increase over the past decade has been much higher./p#13; div class=story-feature narrow#13; a class=hidden href=#story_continues_2Continue reading the main story/a h2 class=quote“spanStart Quote/span/h2#13;blockquote readability=1p class=first-childImproving the flow of patients will be critical to the NHS's ability to cope with future winter pressures on urgent and emergency care services”/p/blockquote#13;span class=endquoteEnd Quote/span#13; span class=quote-creditNational Audit Office/span#13; #13;#13; /div p id=story_continues_2A big factor is the growing proportion of patients attending major Aamp;E departments who are admitted. Ten years ago it was fewer than one in five. Now it is more than one in four. /p#13; pBut the NAO estimates that at least a fifth of patients admitted as emergencies could be managed outside hospital. /p#13; pIt concludes that going to Aamp;E and then being admitted has become the default route for urgent and emergency care. /p#13; pIt also highlights growing delays in discharging patients once they are fit to leave hospital./p#13; pIt says these problems are a major concern, partly because of cost to the NHS, but also because of the disruption they bring to hospitals and to patients. /p#13; pThe report argues that all parts of the health system have a role in ensuring patients are treated in the most appropriate setting. /p#13; pIt says primary, community and social care can manage long-term conditions better. It suggests ambulance services can take fewer patients to Aamp;E, and it calls on hospitals to ensure senior doctors are on hand to help with early diagnosis and treatment./p#13; pThere is added urgency in these findings as the health service prepares for the increased pressures of winter. /p#13; span class=cross-head'Full to bursting'/span#13; pThe director for acute episodes of care for NHS England, Prof Keith Willett, said the increase in emergency admissions was a growing concern./p#13; pAs the report recommends, we must collectively take substantial steps to ensure patients receive the best possible care, preferably out of hospital but also when necessary in hospital, he said./p#13; pTo achieve that it is clear the way we provide health and social care must change so our hospitals, GP and community services have the space to do that./p#13; pIn a statement the College of Emergency Medicine welcomed the NAO report./p#13; pIn particular the recognition that best practice includes consultant supervision of patient care within emergency departments echoes the college campaign to ensure every department has a minimum of 10 consultants./p#13; pFor Labour, shadow health secretary Andy Burnham said the NHS was on the brink of a dangerous winter crisis./p#13; pThis report is right to warn about the increasing numbers of elderly patients being admitted to England's Aamp;Es, Mr Burnham said. /p#13; pWe have long warned ministers that severe cuts to council care services have left hospitals unable to discharge patients, and Aamp;Es full to bursting./p#13; /div/divbrbrcentera href=http://www.wizardrss.comPowered By WizardRSS.com/a | a href=http://www.wizardrss.comFull Text RSS Feed/a | a href=http://www.amazon.com/RFID-Blocking-Cards-Identity-Protector/dp/B00CJHZLEWRFID/a | a href=http://www.wpzonbuilder.comAmazon Affiliate/a/center