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Monthly English A&E statistics for March 2020 published today: https://www.england.nhs.uk/statistics/statistical-work-areas/ae-waiting-times-and-activity/ae-attendances-and-emergency-admissions-2019-20/
I’d">https://www.england.nhs.uk/statistic... normally post an updated chart, but there’s A LOT of important context behind these numbers, so instead, a thread /1
I’d">https://www.england.nhs.uk/statistic... normally post an updated chart, but there’s A LOT of important context behind these numbers, so instead, a thread /1
First off, huge fall in people attending A&E (as @phe_uk weekly updates have also shown: https://www.gov.uk/government/publications/emergency-department-weekly-bulletins-for-2020)
Almost">https://www.gov.uk/governmen... 30% fewer attendances in March 2020 than in March 2019 /2
Almost">https://www.gov.uk/governmen... 30% fewer attendances in March 2020 than in March 2019 /2
This is NOT just a fall in ‘avoidable’ attendances /3
There’s been a big 
https://abs.twimg.com/emoji/v2/... draggable="false" alt="📉" title="Chart with downwards trend" aria-label="Emoji: Chart with downwards trend">in A&E attendances from patients with cardiac problems at same time as https://abs.twimg.com/emoji/v2/... draggable="false" alt="📈" title="Chart with upwards trend" aria-label="Emoji: Chart with upwards trend">in calls to ambulance service for chest pain – suggests some people are holding back on going who should: https://twitter.com/nedwards_1/status/1246000810800173056">https://twitter.com/nedwards_... /4
See also @jamesillman @HSJnews story: https://www.hsj.co.uk/policy-and-regulation/coronavirus-response-could-create-very-serious-unintended-consequences/7027321.article">https://www.hsj.co.uk/policy-an... /5
Perhaps surprisingly, ‘performance’ – the proportion of patients admitted, discharged or transferred within four hours – increased slightly, for third month a row /6
That could be because fewer people are turning up, but little evidence that A&E performance is correlated with volume of attendance... /7
...the number of people who turn up each winter – where performance usually dips – is actually not substantially higher than other months but people turning up tend to need more intensive medical care, for example: https://www.kingsfund.org.uk/projects/urgent-emergency-care/urgent-and-emergency-care-mythbusters">https://www.kingsfund.org.uk/projects/... /8
Slightly more A&E attendees were admitted to hospital this month (31.5%) compared to March last year (29.8%), which might suggest that people now turning up more likely to need intensive care /9 ( https://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2020/04/Statistical-commentary-March-2020-jf8hj.pdf)">https://www.england.nhs.uk/statistic...
So why could performance have improved?
Still unclear – though as @sib313 says, it might be because hospitals had a few more spare beds in their efforts to free up space for Covid 19 patients who hadn’t yet filled them: https://twitter.com/sib313/status/1247169058430021635">https://twitter.com/sib313/st... /10
Still unclear – though as @sib313 says, it might be because hospitals had a few more spare beds in their efforts to free up space for Covid 19 patients who hadn’t yet filled them: https://twitter.com/sib313/status/1247169058430021635">https://twitter.com/sib313/st... /10
Also likely that March was a month of two halves – GP data suggests shift in people not wanting to come in for face-to-face appointments was halfway through March (when govt announced lockdown) – suspect that was also the turning point in A&E: https://www.hsj.co.uk/technology-and-innovation/pandemic-leads-to-huge-change-in-patient-and-gp-behaviour/7027276.article">https://www.hsj.co.uk/technolog... /11
TL;DR – please DON’T CONCLUDE that more people being seen within 4 hours means we should celebrate falling A&E attendances.
Better performance more likely to do with bed numbers; and fall in attendances could be storing up problems! 12/12
Better performance more likely to do with bed numbers; and fall in attendances could be storing up problems! 12/12
