Ealing Hospital to Investigate A&E Frequent Attenders


One person has made more than fifty visits

Harshal Goswami
Harshal Goswami

September 9, 2024

Ealing Hospital is to carry out further investigations in to why some people become high intensity users of the accident and emergency department.

The initiative aims to understand why they attend so frequently and work out other options for their care. Users who attend A&E at least six times in as many months include those with mental health problems, alcohol and substance abuse, long term medical conditions, dementia and frailty, and medically unexplained symptoms.

Harshal Goswami is one of two High Intensity User Case Workers employed by the trust’s two departments earlier this summer. She will be working on a project which is part of a year-long pilot across eight London boroughs and seven emergency departments including Ealing and Northwick Park.

Harshal, who is Ealing’s case worker, said, “We have one individual who has come in more than 50 times but when under observation shows no signs of distress or ill health.

“We look into a patient’s medical history and socio-economic situation to see if there are any underlying patterns to their behaviour and what we can do to help.

“It involves some detective work and I liaise with everyone from housing and social services to community and voluntary groups if we spot a trigger which may be causing frequent attendances.

“It can be something as simple as loneliness or poor living accommodation and we work with agencies to address that. Sometimes, people aren’t confidant enough to self-manage an existing condition like COPD.

The team look at up to 25 cases a month.

Harshal added, “GPs face the same challenges but have a far more comprehensive picture of a patient’s history in the shape of a Universal Care Plan which we try and get hold of.

“It’s all about cause and effect. If we take a step back and find out why something is happening we can hopefully change the outcome.”

Steve Watkins

 

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