This indicator reflects the rate of emergency admissions across all ages.
The NHS offers excellent responsive services when people are at a point of crisis or suffer injury which cannot be dealt with elsewhere. But we know that many of the people who come to hospitals as emergencies could have been offered better support or services earlier on, which would have prevented the need for them to come to hospital, or may have involved a planned visit to hospital.
Emergency admission to hospital is inevitably unplanned and can be a time of stress and anxiety to both the patient and to relatives and friends. For hospital staff decisions have to be made very quickly, sometimes with limited information about the circumstances leading to the emergency, to ensure that the patient's problem is correctly diagnosed and the right treatment given.
Some admissions cannot be avoided. But the more comprehensive our approach to improving health and wellbeing, and the co-ordinated provision of alternatives to hospital care, the less likely we make the need for hospital admissions.
Older people admitted regularly to hospital as an emergency are more likely to be delayed there once their treatment is complete. This, in turn, is particularly bad for their health and independence.
This indicator demonstrates the outcome of work across Community Partnerships to improve health and wellbeing through a wide range of approaches and early interventions. These include work to reduce accidents and improve safety in the home and elsewhere; work focussed on reducing the incidence of particular diseases and life-threatening conditions; support for carers; and anticipatory care and joined-up community and health care services designed to address the challenges of an increasingly ageing population with long-term conditions and complex needs.
A range of factors, some personal, some systems-related, impact on admission numbers. At a personal level, these would include the particular form of the current problem, the individual's own health and well-being and whether the person looks after themselves or lives with family or needs a carer.
For some people their immediate housing environment is also important; can they, for example, reach an upstairs toilet. Systems-related aspects include: the options open to GPs in referring patients directly to hospital; decisions made by ambulance crews on arrival at an emergency situation; and for older people in particular the availability of alternative forms of care such as short term rapid response services; and whether local systems are linked in a way that supports older people at these critical times.
The Government offers strategic leadership and support across the range of approaches and services that will influence the rate of emergency admissions to hospital.
Community Planning Partnerships have a major role in delivering progress on this indicator. It can be achieved by collaborative working upstream to improve health and address health inequalities, to promote healthy and safe communities, environments and lifestyles. Where people do need support, agencies can work together to develop a more joined-up preventative and supportive home care service, to improve sharing of appropriate data between agencies and ensuring that people have their needs for care properly assessed through, for example, single shared assessment.
The Government works with COSLA to support Community Planning Partnerships, encourages continuous improvement through targets, the redesign of NHS primary care services and the facilitation of joint working.
The provisional figure for 2015/16 of 10,559 per 100,000 population represents a 0.4% decrease on 10,599 per 100,000 population in 2014/15.
The data is available at the bottom of the page.
Data for 2015/16 are provisional, with a small number of cases still to be counted, however are considered complete at Scotland level. This level of completeness may vary at NHS Board level. This is due to temporary backlogs in data submissions, which have been affected by the implementation of a new IT Patient Management System. Therefore provisional figures for the number of beds are likely to increase. Finalised figures for 2015/16 are expected to be published next year, along with provisional figures for 2016/17.
The NHS Boards are working to resolve these submission issues. Further details are available on the ISD website - Hospital Records Data Monitoring SMR Completeness page.
In 2015/16, the rate of emergency admissions for the youngest age group (aged 0 to 4) was 14,444 per 100,000 population. The number of emergency admissions then decreases with age for those aged 5-9 years (4,177 per 100,000 population) and 10-14 years (3,550 per 100,000 population), after which the number of admissions increases with age reaching 51,111 per 100,000 population for those aged 85 and over.
Between 2014/15 and 2015/16, the rate of emergency admissions increased for the youngest age group (aged 0 to 4). Whereas it decreased for all age groups aged 70 and up.
The data is available at the bottom of the page.
*Please note the criteria for recent change was revised in the October 2016 update.
The threshold for determining the direction of change accounts for the fact that the provisional figure tends to be an underestimate due to delays in submitting data by various Health Boards. This means that the final revised figure will always be an increase on the provisional figure. To reflect this, the thresholds for change compared to the previous year’s figure are: an increase greater than 0 for “Performance Worsening”, a decrease between 0 and 200 for “Performance Maintaining”, whereas a decrease greater than 200 is given a “Performance Improving” rating.
For information on general methodological approach, please click here.
Scotland Performs Technical Note
Third and independent sector providers of care
Wealthier and Fairer
Safer and Stronger