The NHS is using AI to predict patients who are at risk of becoming frequent users of emergency services so staff can get them more appropriate care at an earlier stage.
The intervention will ensure that thousands of people get the support they need earlier, while also reducing demand on pressured A&Es.
Over 360,000 patients attend A&E more than five times every year, but now, using data-powered initiatives to identify them, NHS teams are proactively reaching out with support before they walk through the front door of an emergency room.
High Intensity Use (HIU) services use the latest data to find the most regular attendees in their area to identify and resolve the reasons patients are coming forward for care so regularly – often associated with poverty and social isolation.
The NHS has rolled out HIU services to support more than 125 emergency departments across England so far, providing patients with one-to-one coaching support in their own homes to tackle the root cause of why they are visiting A&E.
Initiatives like this have already helped reduce the number of frequent attendances by more than half in some parts of the country. South Tees Hospitals NHS Foundation Trust recruited a dedicated keyworker to offer social, practical and emotional support to 20 HIU individuals and helped them more than halve their visits to A&E – down from 33 times per year.
In North East London, teams are harnessing the power of AI technology to predict those patients who are at risk of frequently attending A&E.
The AI-powered prediction software uses routinely collected hospital data to identify patients who require immediate preventative support to avoid future, unplanned visits to the hospital.
This includes supporting patients with long-term conditions, like asthma or diabetes, and having a healthcare professional reach out to them to offer them personalised, preventative support and self-management techniques.
Targeted
Amanda Pritchard, NHS Chief Executive said: “The NHS is going into winter busier than ever before and as ever, despite huge pressure and a potential ‘quad-demic’, our incredible staff are doing everything within their power to provide the best possible care to patients.
“We know that a small proportion of the population are much more likely to use A&E or ambulance services, so it is important we give them the targeted support they need this winter before they get to the front door of an emergency service – this is much better for them but will also help to relieve pressure on the NHS.
“Initiatives like using AI to spot those who may need extra support in the community help provide more personalised care and must be central to our 10 Year Health Plan.”
Health Minister Karin Smyth said: “We inherited a broken NHS that is dealing with record admissions heading into winter, which is why we’re investing £26 billion in the health service and have set out our Plan for Change to get the NHS back on its feet.
“But investment must come with reform, and these fantastic services are great examples of how innovation and partnership working can transform the NHS.
“They offer a double win for getting vulnerable patients the right support and saving the precious time of busy A&E staff.
“We want to share more of this best practice through the three shifts in our 10 Year Health Plan – moving from hospital to community, analogue to digital, and treatment to prevention.”
NHS teams in Wolverhampton created a High Intensity Use service to recognise people in crisis and improve the health outcomes of those who face the highest deprivation and health inequalities in their area.
The service, combining community outreach with a dedicated clinical lead, led to a significant improvement in the wellbeing of frequent attenders and a reduction in hospital attendance by almost three fifths (58%).
Conditions
Ryan*, 23, was contacted by the team after multiple hospital visits with chest pain and experience of suicidal thoughts after losing his job. Staff supported Ryan all the way back into employment and he has had no further A&E attendances since.
Norfolk Community Health and Care NHS Trust also established a HIU service who worked closely with over 400 of the most frequent attenders to A&E, including one service user, Chris*, who suffered from a serious condition and was regularly visiting A&E, sometimes as often as twice a week.
The HIU service contacted Chris and worked with him on a one-to-one basis to ensure he was accessing the correct support, helping him to deal with his housing issues and to start looking for work again.
Since he started working with the HIU service, Chris has not visited the emergency department or dialled 999 again, contributing to the Trust’s 58% reduction of A&E attendances from frequent attenders, and a reduction in hospital admissions of 62%.
Chris said: “It was good to have someone who was on my level and not against me – I feel I have come a long way.”
*Some names have been changed for confidentiality.
