Four-hour A&E waiting target led to a surge in admissions says study

Near-50% rise in child admissions blamed on time constraint

Pressure on emergency departments to see patients within four hours has led to a rise in “avoidable” child admissions, according to a new study.

The number of children admitted to hospital in Scotland as emergency referrals rose almost 50% across the 13-year period of data, but researchers found no evidence of a growth in youngsters getting seriously ill.

Of the increased number of admissions who were discharged the same day, the vast majority were usually treated with only clear fluids and paracetamol – which could be done at home.

Aberdeen University researchers suggest the surge may be due to a number of factors, including pressure on emergency departments to see patients within four hours, which have added unnecessary workloads to hospital staff.

Professor Steve Turner, consultant paediatrician at Royal Aberdeen Children’s Hospital, said: “If you go into an emergency department, within four hours a decision has to be made – do we admit or do we not admit them.

“In the old days, emergency departments would be able to observe children and decide whether they have to be admitted, now they have to decide quickly – they don’t have the luxury of sitting and watching a child.

“The fact that these children are coming all the way into hospital and then being sent home on the same day after receiving treatment they could have got at home suggests that many emergency admissions are potentially avoidable.

“This is a big problem and something needs to change.”

He added: “If we can better educate parents with clear and easy-tounderstand information they may have a clear understanding of when to ask for help and when not to.

“Of course we don’t want to put parents off contacting the doctor when they think something is wrong.”

The study, published in the European Journal of Pediatrics, found the number of paediatric emergency admissions increased 49% between 2000 and 2013.

It went from 36/1,000 children to 54/1,000 by the end of the period.

Within four hours a decision has to be made –dowe admit or do we not admit them. PROFESSOR STEVE TURNER