GP referrals to St Mary’s Hospital have dropped by more than 50% over last year but emergency admissions of the over 70s are on the rise.

Isle of Wight NHS Trust bosses say patients continue to turn up at the emergency department at St Mary’s Hospital, in Newport, requiring urgent care when it could have been treated beforehand.

Those emergency admissions have increased by 15%, when compared to October last year.

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Speaking at a meeting of the trust board last week, Joe Smyth, chief operating officer, said on the face of it fewer referrals from GPs may seem like a good thing but the patients not being seen may be getting worse and will end up being admitted to hospital. He said:

“It is true to say we are seeing an increase of emergency admissions coming into the hospital and it is true the majority of that increase is in the over 70s.”

From 19th-25th October, 325 referrals were made from GPs, compared to 705 in the same week last year — a drop of 54%. In the 4 weeks prior to that, referrals were only at 65% of what they were last year.

A break-the-cycle event is underway this week, conducted by the Isle of Wight NHS Trust with community and primary care providers, to see if they can reach out and assess the most needy.

Mr Smyth said they were able to identify who those patients are by looking at records and seeing who are ‘often responsible for a significant number of admissions’, being admitted 3 or 4 times in the past year.

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Due to the COVID-19 pandemic, changes made to the emergency department and the increase of emergency admissions have led to significant pressures. Bed capacity has been reduced by 10% to keep COVID positive patients away from other, while gaps in staffing filled by temporary postings with doctors unfamiliar to the trust’s processes and model of care.

Mr Smyth said he wanted to assure everyone the hospital is safe but the break-the-cycle event will look at ways of solving some of those problems — how to better manage patients in the emergency department, how to better discharge patients and looking at the central process to ensure people are being processed as quickly as possible. He said:

“The purpose of this is to see if our theory around people not accessing primary care because of the virtual world and they are worried about coming out is there and we do that by reaching out into people’s homes.”

Maggie Oldham, chief executive, said primary care colleagues are busier now than they were last year but the increase of emergency admissions felt like it is another cohort of patients presenting to the hospital, instead of those skipping primary care and coming straight to the hospital.

However, a lack of evidence and data is yet to confirm that but is being worked on by the NHS trust.

Island Echo