690,000 A&E attendances could be avoided if people were supported to better manage their long-term conditions

New research by the Health Foundation, published today in the BMJ Quality and Safety journal, looks at how well patients feel able to manage their long-term conditions such as asthma, diabetes and depression.

It finds that those who felt most confident and able to manage their condition and keep themselves well had 38% fewer emergency admissions and 32% fewer A&E attendances than those who felt least able.

People who felt most able to manage their mental health conditions, as well as any physical health conditions, had 49% fewer emergency admissions than the patients who felt least able.

If patients were better supported to manage their long-term conditions – for example, through health coaching, peer support or greater access to apps that help people to manage symptoms and avoid deteriorations – this could lead to a reduction in emergency admissions to hospital, A&E attendances and GP appointments. 

In the best-case scenario, if the patients who currently feel least able to manage their conditions were supported to manage their conditions as well as those who feel most able, this could prevent 436,000 emergency admissions to hospital and 690,000 attendances at A&E each year. This equates to 7% of the total number of emergency admissions and 6% of A&E attendances in England each year.    

The research, which looked at levels of knowledge, skill and confidence in self-management for over 9,000 adults with long term conditions, is the first NHS study to demonstrate a link between self-management and patients’ use of health services across both primary and secondary care. As well as having fewer emergency admissions and A&E attendances, the patients who felt most able to manage their health had 18% fewer general practice appointments.  

In the study, just 13% of patients felt knowledgeable about their health condition and confident to plan and manage their care. While almost a quarter (22%) were likely to feel overwhelmed by the demands of their long-term condition and not take an active role in their own care.

Over the last 12 years, the number of emergency hospital admissions in England has increased by 42% from 4.25 million in 2006/07 to 6.02 million in 2017/18. Over 60% of patients admitted to hospital as an emergency have one or more long-term health conditions such as asthma, diabetes or a mental illness.

Sarah Deeny, Assistant Director of Data Analytics at the Health Foundation, said:

‘Patients with long-term conditions manage the majority of their care, spending less than 1% of their time in contact with a health professional. Supporting these patients to develop the necessary skills, knowledge and confidence to manage their health as effectively as possible is critical to helping them stay well and could help reduce the need for a vast number of emergency admissions, A&E attendances and GP appointments.

‘To ease pressure on services and improve patients’ quality of life, national policy makers and the local NHS must take action now to support people to better manage their long-term conditions. This should include NHS England prioritising support for self-management in the long-term plan for the NHS.’ 

To accompany the research published in BMJ Quality and Safety, the Health Foundation is also publishing a briefing that summarises the findings and identifies some solutions.

Media contacts

Susannah McIntyre
External Affairs Manager (Media)
susannah.mcintyre@health.org.uk
020 7664 4658

Simon Perry
External Affairs Manager (Media)
simon.perry@health.org.uk
020 7257 8000