A&E Demand Management

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Pressure on the healthcare system increases during the extreme weather in both winter and summer. This burden affects both GP practices and trusts, however there are a number of ways that practices can help to reduce A&E demand and support the overall health landscape.


Frequent Emergency Department Attenders

  • Use NELIE to identify the highest users of ED within the practice
  • Check whether these patients have been discussed at the Integrated Network meetings and if they have a management plan in place.  Some of these patients need extra social support (e.g. help to attend medical appointments) which can be facilitated through the MDT.
  • Review discharge summaries to identify patterns of frequent attendance and call patients in for consultation.
  • Offer frequent attenders a same day appointment rather than a future appointment; this can help to avoid unnecessary attendances at A&E/UTC
  • High Intensity User Group – Whittington.  This group meets once a month at the Whittington.  Practices can input by contacting the ED manager, Michelle Scully: michelle.scully@nhs.net 
  • Send text to patients who use A&E inappropriately outlining the services that your practice offers and reiterating the message that A&E should only be used for emergencies (see Hanley Road example attached)



  • Prioritise children and young people for same day appointments.
  • There is often a spike in attendances after school (3.30pm-5.30pm) so consider increasing the number of duty doctor appointments for this period if you have a high population of younger people at your practice.


Telephone Triage

  • Free up clinic time by offering more Telephone Triage.  This change has been successful in some practices where there has been higher than usual A&E activity.  Pharmacists could also offer phone triage.


Urgent Care: iHUB (Extended Access)

  • Check your usage of the extended access service; many practices are still underusing  iHUB. 
  • Booking more iHUB appointments could  reduce pressure on both UTC ( Urgent Treatment Centre) and the practice.
  • Please ensure that all your receptionists are aware of the service and are using the script that was shared earlier in the year.