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Better use of technology could slash A&E costs

The cost of emergency hospital admissions could be cut by up to £1 billion annually through the better use of medical technology in just three clinical areas, according to a report compiling data requested from every acute Trust and Clinical Commissioning Groups in England.

Research by the Medical Technology Group (MTG), a coalition of patient groups, research charities and medical device manufacturers, looked at three conditions: heart failure, diabetes and urinary tract infections (UTIs). It found that unplanned admissions for these conditions alone affected nearly 400,000 patients a year, with a combined cost of just over £1 billion.

The data, obtained by a Freedom of Information request to which 274 acute Trusts and Clinical Commissioning Groups (CCGs) responded, showed that in 2013/14:

  • Each NHS Trust handled on average 102 deaths from congestive heart failure, with unplanned admissions costing nearly £350 million.
  • Over £200 million is spent treating patients for unplanned admissions owing to diabetes emergencies with an average cost per patient of £4,477.
  • The NHS in England spent £434 million in 2013/14 on treating 184,000 hospital admissions for a urinary tract infection. On average CCGs received £2.1 million each for handling unplanned admissions for UTIs, while CCGs spent an average of £84,609 per year on unplanned admissions for blocked catheters alone.

Screen shot 2015-11-24 at 16.02.34The MTG’s report, ‘Admissions of failure – the truth about unplanned NHS admissions in England,’ also finds huge regional variation in the treatment of heart failure. For example, 66% of congestive heart failure patients in the Southwest were treated in hospital, compared to just 16% in the West Midlands. There is also huge variation in death rates from heart failure, ranging from 7.4% of patients treated for the condition in the Eastern region compared to 27.8% the North East.

The report calls for the better use of medical technology solutions to tackle unplanned admissions in these areas, including:

  • Cardiac devices, such as implantable cardioverter defibrillators (ICDs), which have an overwhelmingly positive clinical record for preventing deaths and hospital admissions for heart failure patients. The UK currently ranks 21st in Western Europe for ICD implant rates, behind countries like Greece, Slovakia and Malta.
  • Insulin pumps for Type 1 diabetes patients: at present only around six% of adult Type 1 diabetes patients use an insulin pump, half of the 12% recommended by the National Institute for Health and Care Excellence (NICE).
  • Anti-infective Foley catheters, bladder ultrasound scanners and catheter technology that minimises breakages between the catheter and drainage bag. Nottingham University Hospitals NHS Trust reduced catheter-associated urinary tract infections by 44% in six months thanks to Foley technology and training.

In an open letter to the Secretary of State for Health, the Rt Hon Jeremy Hunt PC MP, some of the country’s foremost medical practitioners, leading patient groups, and industry leaders joined Virendra Sharma MP, a member of the Health Select Committee in 2014–15, in calling on the Government to jointly tackle the issue with the NHS and implement medical technology solutions that improve patient care and reduce the unforeseen strain on NHS expenditure.

Speaking at an event at the House of Commons to mark Medical Technology Week (16–20 November), Barbara Harpham, Chair of the Medical Technology Group, said, “There is clear and compelling evidence from within the NHS itself as well as from other developed health economies to show that technology can improve our ability to predict, diagnose and treat diseases – including long-term conditions – and so dramatically reduce unplanned admissions for patients lucky enough to have access to it.  And for the NHS, better managed demand means radical savings on Accident & Emergency (A&E) spend.”

A full copy of the report: ‘Admissions of failure – the truth about unplanned NHS admissions in England’ is available on request.

Published on: November 24, 2015

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