overview of sec admissions activity. data sources ambulance calls & a&e attendances from...
TRANSCRIPT
Overview of SEC Admissions Activity
Data Sources
• Ambulance Calls & A&E Attendances from Weekly SITREP
• Inpatient data sourced from SUS / trust extracts• All data points on charts are a rolling 12 month /
52 week average to remove seasonal variation• All inpatient data is plotted by date of discharge• Bed days are calculated from patients
discharged in that period
2008/09 Patch Totals
• 373k Category A and B Ambulance Calls• 1.52m A&E Attendances• Emergency Admissions
– 388k Admissions– £553m PbR Value – 2m Bed Days
• Short Stay Emergency Admits (0/1 day)– 194k Admissions– £45.1m PbR Value– 83k Bed Days
Growth in Ambulance Cat A / BCalls
80%
85%
90%
95%
100%
105%
110%
115%
120%
125%
130%
01/0
4/20
07
29/0
4/20
07
27/0
5/20
07
24/0
6/20
07
22/0
7/20
07
19/0
8/20
07
16/0
9/20
07
14/1
0/20
07
11/1
1/20
07
09/1
2/20
07
06/0
1/20
08
03/0
2/20
08
02/0
3/20
08
30/0
3/20
08
27/0
4/20
08
25/0
5/20
08
22/0
6/20
08
20/0
7/20
08
17/0
8/20
08
14/0
9/20
08
12/1
0/20
08
09/1
1/20
08
07/1
2/20
08
04/0
1/20
09
01/0
2/20
09
01/0
3/20
09
29/0
3/20
09
26/0
4/20
09
24/0
5/20
09
21/0
6/20
09
19/0
7/20
09
16/0
8/20
09
13/0
9/20
09
11/1
0/20
09
Cat A
Cat B
Total
Total Cat A + Cat B calls have risen steadily growing 12% from Apr 2007
70%
80%
90%
100%
110%
120%
130%
01/0
4/20
07
29/0
4/20
07
27/0
5/20
07
24/0
6/20
07
22/0
7/20
07
19/0
8/20
07
16/0
9/20
07
14/1
0/20
07
11/1
1/20
07
09/1
2/20
07
06/0
1/20
08
03/0
2/20
08
02/0
3/20
08
30/0
3/20
08
27/0
4/20
08
25/0
5/20
08
22/0
6/20
08
20/0
7/20
08
17/0
8/20
08
14/0
9/20
08
12/1
0/20
08
09/1
1/20
08
07/1
2/20
08
04/0
1/20
09
01/0
2/20
09
01/0
3/20
09
29/0
3/20
09
26/0
4/20
09
24/0
5/20
09
21/0
6/20
09
19/0
7/20
09
16/0
8/20
09
13/0
9/20
09
11/1
0/20
09
Cons Led 24 Hour
Cons Led Single Specialty
Other / WIC / MIUs
Total
Overall A&E attendances have grown 5% from Apr 07
Variance in growth between types accounted for by organisational change – moving minors to MIUs / WICs
Growth in Average Weekly A&E Attendances
80%
90%
100%
110%
120%
130%
140%A
pr-
07
May
-07
Jun-
07
Jul-0
7
Au
g-0
7
Se
p-0
7
Oct
-07
No
v-0
7
De
c-0
7
Jan-
08
Fe
b-0
8
Mar
-08
Ap
r-0
8
May
-08
Jun-
08
Jul-0
8
Au
g-0
8
Se
p-0
8
Oct
-08
No
v-0
8
De
c-0
8
Jan-
09
Fe
b-0
9
Mar
-09
Ap
r-0
9
May
-09
Jun-
09
Jul-0
9
Growth in Average Monthly Emergency Admissions
Overall growth of 12% seen in emergency admissions from March 2007
Trust 1
80%
90%
100%
110%
120%
130%
140%
Ap
r-0
7Ju
n-0
7A
ug
-07
Oct
-07
De
c-0
7F
eb
-08
Ap
r-0
8Ju
n-0
8A
ug
-08
Oct
-08
De
c-0
8F
eb
-09
Ap
r-0
9Ju
n-0
9
Trust 3
80%
90%
100%
110%
120%
130%
140%
Ap
r-0
7Ju
n-0
7A
ug
-07
Oct
-07
De
c-0
7F
eb
-08
Ap
r-0
8Ju
n-0
8A
ug
-08
Oct
-08
De
c-0
8F
eb
-09
Ap
r-0
9Ju
n-0
9
Trust 4
80%
90%
100%
110%
120%
130%
140%
Ap
r-0
7Ju
n-0
7A
ug
-07
Oct
-07
De
c-0
7F
eb
-08
Ap
r-0
8Ju
n-0
8A
ug
-08
Oct
-08
De
c-0
8F
eb
-09
Ap
r-0
9Ju
n-0
9
Trust 2
80%
90%
100%
110%
120%
130%
140%
Ap
r-0
7Ju
n-0
7A
ug
-07
Oct
-07
De
c-0
7F
eb
-08
Ap
r-0
8Ju
n-0
8A
ug
-08
Oct
-08
De
c-0
8F
eb
-09
Ap
r-0
9Ju
n-0
9
Trust 8
80%
90%
100%
110%
120%
130%
140%
Ap
r-0
7Ju
n-0
7A
ug
-07
Oct
-07
De
c-0
7F
eb
-08
Ap
r-0
8Ju
n-0
8A
ug
-08
Oct
-08
De
c-0
8F
eb
-09
Ap
r-0
9Ju
n-0
9
Trust 9
80%
90%
100%
110%
120%
130%
140%
Ap
r-0
7Ju
n-0
7A
ug
-07
Oct
-07
De
c-0
7F
eb
-08
Ap
r-0
8Ju
n-0
8A
ug
-08
Oct
-08
De
c-0
8F
eb
-09
Ap
r-0
9Ju
n-0
9
Emergency Admissions
Trust 7
80%
90%
100%
110%
120%
130%
140%
Ap
r-0
7Ju
n-0
7A
ug
-07
Oct
-07
De
c-0
7F
eb
-08
Ap
r-0
8Ju
n-0
8A
ug
-08
Oct
-08
De
c-0
8F
eb
-09
Ap
r-0
9Ju
n-0
9
Trust 5
80%
90%
100%
110%
120%
130%
140%
Ap
r-0
7Ju
n-0
7A
ug
-07
Oct
-07
De
c-0
7F
eb
-08
Ap
r-0
8Ju
n-0
8A
ug
-08
Oct
-08
De
c-0
8F
eb
-09
Ap
r-0
9Ju
n-0
9
Trust 6
80%
90%
100%
110%
120%
130%
140%
Ap
r-0
7Ju
n-0
7A
ug
-07
Oct
-07
De
c-0
7F
eb
-08
Ap
r-0
8Ju
n-0
8A
ug
-08
Oct
-08
De
c-0
8F
eb
-09
Ap
r-0
9Ju
n-0
9
Trust 10
80%
90%
100%
110%
120%
130%
140%
Ap
r-0
7Ju
n-0
7A
ug
-07
Oct
-07
De
c-0
7F
eb
-08
Ap
r-0
8Ju
n-0
8A
ug
-08
Oct
-08
De
c-0
8F
eb
-09
Ap
r-0
9Ju
n-0
9
Trust 11
80%
90%
100%
110%
120%
130%
140%
Ap
r-0
7Ju
n-0
7A
ug
-07
Oct
-07
De
c-0
7F
eb
-08
Ap
r-0
8Ju
n-0
8A
ug
-08
Oct
-08
De
c-0
8F
eb
-09
Ap
r-0
9Ju
n-0
9
Patch 1 Patch 2 Patch 3
Spells - RH Axis
Trust LoS - LH AxisSHA LoS - LH Axis
Growth in 12 Month Average from March 2007
Some variation by trust across patch but nearly all showing some growth and 4 trusts showing significant growth above patch average
80%
90%
100%
110%
120%
130%
140%
Apr
-07
May
-07
Jun-
07
Jul-0
7
Aug
-07
Sep
-07
Oct
-07
Nov
-07
Dec
-07
Jan-
08
Feb
-08
Mar
-08
Apr
-08
May
-08
Jun-
08
Jul-0
8
Aug
-08
Sep
-08
Oct
-08
Nov
-08
Dec
-08
Jan-
09
Feb
-09
Mar
-09
Apr
-09
May
-09
Jun-
09
Jul-0
9
Growth in Average Monthly Emergency Bed Days
Bed days also grown, although only by around 3-4%, much lower than admissions
Trust 1
80%
90%
100%
110%
120%
130%
140%
Ap
r-0
7Ju
n-0
7A
ug
-07
Oct
-07
De
c-0
7F
eb
-08
Ap
r-0
8Ju
n-0
8A
ug
-08
Oct
-08
De
c-0
8F
eb
-09
Ap
r-0
9Ju
n-0
9
Trust 3
80%
90%
100%
110%
120%
130%
140%
Ap
r-0
7Ju
n-0
7A
ug
-07
Oct
-07
De
c-0
7F
eb
-08
Ap
r-0
8Ju
n-0
8A
ug
-08
Oct
-08
De
c-0
8F
eb
-09
Ap
r-0
9Ju
n-0
9
Trust 4
80%
90%
100%
110%
120%
130%
140%
Ap
r-0
7Ju
n-0
7A
ug
-07
Oct
-07
De
c-0
7F
eb
-08
Ap
r-0
8Ju
n-0
8A
ug
-08
Oct
-08
De
c-0
8F
eb
-09
Ap
r-0
9Ju
n-0
9
Trust 2
80%
90%
100%
110%
120%
130%
140%
Ap
r-0
7Ju
n-0
7A
ug
-07
Oct
-07
De
c-0
7F
eb
-08
Ap
r-0
8Ju
n-0
8A
ug
-08
Oct
-08
De
c-0
8F
eb
-09
Ap
r-0
9Ju
n-0
9
Trust 8
80%
90%
100%
110%
120%
130%
140%
Ap
r-0
7Ju
n-0
7A
ug
-07
Oct
-07
De
c-0
7F
eb
-08
Ap
r-0
8Ju
n-0
8A
ug
-08
Oct
-08
De
c-0
8F
eb
-09
Ap
r-0
9Ju
n-0
9
Trust 9
80%
90%
100%
110%
120%
130%
140%
Ap
r-0
7Ju
n-0
7A
ug
-07
Oct
-07
De
c-0
7F
eb
-08
Ap
r-0
8Ju
n-0
8A
ug
-08
Oct
-08
De
c-0
8F
eb
-09
Ap
r-0
9Ju
n-0
9
Emergency Bed Days
Trust 7
80%
90%
100%
110%
120%
130%
140%
Ap
r-0
7Ju
n-0
7A
ug
-07
Oct
-07
De
c-0
7F
eb
-08
Ap
r-0
8Ju
n-0
8A
ug
-08
Oct
-08
De
c-0
8F
eb
-09
Ap
r-0
9Ju
n-0
9
Trust 5
80%
90%
100%
110%
120%
130%
140%
Ap
r-0
7Ju
n-0
7A
ug
-07
Oct
-07
De
c-0
7F
eb
-08
Ap
r-0
8Ju
n-0
8A
ug
-08
Oct
-08
De
c-0
8F
eb
-09
Ap
r-0
9Ju
n-0
9
Trust 6
80%
90%
100%
110%
120%
130%
140%
Ap
r-0
7Ju
n-0
7A
ug
-07
Oct
-07
De
c-0
7F
eb
-08
Ap
r-0
8Ju
n-0
8A
ug
-08
Oct
-08
De
c-0
8F
eb
-09
Ap
r-0
9Ju
n-0
9
Trust 10
80%
90%
100%
110%
120%
130%
140%
Ap
r-0
7Ju
n-0
7A
ug
-07
Oct
-07
De
c-0
7F
eb
-08
Ap
r-0
8Ju
n-0
8A
ug
-08
Oct
-08
De
c-0
8F
eb
-09
Ap
r-0
9Ju
n-0
9
Trust 11
80%
90%
100%
110%
120%
130%
140%
Ap
r-0
7Ju
n-0
7A
ug
-07
Oct
-07
De
c-0
7F
eb
-08
Ap
r-0
8Ju
n-0
8A
ug
-08
Oct
-08
De
c-0
8F
eb
-09
Ap
r-0
9Ju
n-0
9
Patch 1 Patch 2 Patch 3
Spells - RH AxisTrust LoS - LH AxisSHA LoS - LH Axis
Growth in 12 Month Average from March 2007
Again considerable variation by trust across patch but nearly all showing some growth, note that growth in bed days does not necessarily follow growth in admissions
ASPH
30%
35%
40%
45%
50%
55%
60%
Ma
r-0
7M
ay-
07
Jul-0
7S
ep
-07
No
v-0
7Ja
n-0
8M
ar-
08
Ma
y-0
8Ju
l-08
Se
p-0
8N
ov-
08
Jan
-09
Ma
r-0
9M
ay-
09
Jul-0
9
BSUH
30%
35%
40%
45%
50%
55%
60%
Ma
r-0
7M
ay-
07
Jul-0
7S
ep
-07
No
v-0
7Ja
n-0
8M
ar-
08
Ma
y-0
8Ju
l-08
Se
p-0
8N
ov-
08
Jan
-09
Ma
r-0
9M
ay-
09
Jul-0
9
ESHT
30%
35%
40%
45%
50%
55%
60%
Ma
r-0
7M
ay-
07
Jul-0
7S
ep
-07
No
v-0
7Ja
n-0
8M
ar-
08
Ma
y-0
8Ju
l-08
Se
p-0
8N
ov-
08
Jan
-09
Ma
r-0
9M
ay-
09
Jul-0
9
Frimley
30%
35%
40%
45%
50%
55%
60%
Ma
r-0
7M
ay-
07
Jul-0
7S
ep
-07
No
v-0
7Ja
n-0
8M
ar-
08
Ma
y-0
8Ju
l-08
Se
p-0
8N
ov-
08
Jan
-09
Ma
r-0
9M
ay-
09
Jul-0
9
SASH
30%
35%
40%
45%
50%
55%
60%
Ma
r-0
7M
ay-
07
Jul-0
7S
ep
-07
No
v-0
7Ja
n-0
8M
ar-
08
Ma
y-0
8Ju
l-08
Se
p-0
8N
ov-
08
Jan
-09
Ma
r-0
9M
ay-
09
Jul-0
9
WSHT
30%
35%
40%
45%
50%
55%
60%
Ma
r-0
7M
ay-
07
Jul-0
7S
ep
-07
No
v-0
7Ja
n-0
8M
ar-
08
Ma
y-0
8Ju
l-08
Se
p-0
8N
ov-
08
Jan
-09
Ma
r-0
9M
ay-
09
Jul-0
9
% of Emergency Admissions with LoS of 0 or 1 Day
RSC
30%
35%
40%
45%
50%
55%
60%
Ma
r-0
7M
ay-
07
Jul-0
7S
ep
-07
No
v-0
7Ja
n-0
8M
ar-
08
Ma
y-0
8Ju
l-08
Se
p-0
8N
ov-
08
Jan
-09
Ma
r-0
9M
ay-
09
Jul-0
9
D&G
30%
35%
40%
45%
50%
55%
60%
Ma
r-0
7M
ay-
07
Jul-0
7S
ep
-07
No
v-0
7Ja
n-0
8M
ar-
08
Ma
y-0
8Ju
l-08
Se
p-0
8N
ov-
08
Jan
-09
Ma
r-0
9M
ay-
09
Jul-0
9
EKH
30%
35%
40%
45%
50%
55%
60%
Ma
r-0
7M
ay-
07
Jul-0
7S
ep
-07
No
v-0
7Ja
n-0
8M
ar-
08
Ma
y-0
8Ju
l-08
Se
p-0
8N
ov-
08
Jan
-09
Ma
r-0
9M
ay-
09
Jul-0
9
M&TW
30%
35%
40%
45%
50%
55%
60%
Ma
r-0
7M
ay-
07
Jul-0
7S
ep
-07
No
v-0
7Ja
n-0
8M
ar-
08
Ma
y-0
8Ju
l-08
Se
p-0
8N
ov-
08
Jan
-09
Ma
r-0
9M
ay-
09
Jul-0
9
Medway
30%
35%
40%
45%
50%
55%
60%
Ma
r-0
7M
ay-
07
Jul-0
7S
ep
-07
No
v-0
7Ja
n-0
8M
ar-
08
Ma
y-0
8Ju
l-08
Se
p-0
8N
ov-
08
Jan
-09
Ma
r-0
9M
ay-
09
Jul-0
9
Surrey Sussex Kent
Trust - LH AxisSHA - LH Axis
Rolling 12 Month Averages from March 2007
Proportion of emergency admissions that are short stay has grown slightly across SHA however certain trusts have significantly increased their short stay admissions potentially to improve performance against the A&E 4 hour standard
Summary
• Ambulance Cat A + B Calls grown by 12%• A&E Attendances grown by 5%• Emergency admissions up 12% however individual trusts
show significantly higher growth• Emergency bed days up 3-4%, however, individual trusts
show significantly higher growth• Potentially evidence of unnecessary short stay
admissions in some trusts
