{
  "abstract": "Emergency Departments (EDs) in England experience sustained crowding, affecting patient and staff experience, safety and system flow. This programme of work aimed to identify opportunities where patients attending London EDs could have been managed safely in alternative settings, and to explore what this reveals about system design, access and behaviour within the London Urgent and Emergency Care (UEC) system. A cross-sectional retrospective observational study reviewed over 2,000 patient attendances across 27 London Type 1 EDs between October 2021 and October 2023. Multidisciplinary panels assessed appropriateness and potential alternative pathways. Between 66% and 81% of patients were judged suitable for non-ED care, yet only 29% were redirected or streamed away. These findings largely reflected whole-system factors rather than the performance of individual organisations.",
  "abstract_shown": true,
  "affiliations": [
    "Corresponding author.",
    "NHS England, London Region, 10 South Colonnade, Canary Wharf, London, E14 4PU, United Kingdom"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Catherine Wilson, BA (Hons) Paramedic (HCPC)"
    },
    {
      "affs": [
        1
      ],
      "name": "Sanjeet Johal, MRPharmS MSc PGDip"
    },
    {
      "affs": [
        1
      ],
      "name": "Gary Davies, MBBS DipAvMed MD FRCPE"
    },
    {
      "affs": [
        1
      ],
      "name": "Susan M. Robinson, MB BS FRCP FRCEM"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4k01e1ezjh51v.bib",
  "cited_by": 0,
  "doi": "10.1016/j.fhj.2026.100572",
  "fulltext_url": "http://www.sciencedirect.com/science/article/pii/S2514664526000743",
  "id": "4k01e1ezjh51v",
  "issns": [
    "2514-6645",
    "2514-6653"
  ],
  "landing_url": "https://doi.org/10.1016/j.fhj.2026.100572",
  "language": "en",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research Paper"
    ],
    [
      "lcc",
      "R"
    ],
    [
      "openalex",
      "2711|Emergency and Acute Care Studies"
    ]
  ],
  "openalex": "W7220845848",
  "pdf_url": "https://www.sciencedirect.com/science/article/pii/S2514664526000743/pdf",
  "pmcid": "PMC13720474",
  "pmid": "42964637",
  "published": "2026-10-07",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/4k01e1ezjh51v.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:44:58Z",
      "native_id": "c7ab5e999ac84380a48e92dd548a007b",
      "source": "doaj",
      "url": "https://doi.org/10.1016/j.fhj.2026.100572"
    },
    {
      "first_seen": "2026-10-31T12:21:37Z",
      "native_id": "PMC:PMC13720474",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13720474"
    },
    {
      "first_seen": "2026-11-03T12:21:20Z",
      "native_id": "PMC13720474",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.fhj.2026.100572"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2711|Emergency and Acute Care Studies",
      "subfield": "general"
    }
  ],
  "title": "How many patients attending London Emergency Departments could be managed elsewhere? A whole-system review of missed opportunities for care in more appropriate settings",
  "title_text": "How many patients attending London Emergency Departments could be managed elsewhere? A whole-system review of missed opportunities for care in more appropriate settings",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:21:20Z",
  "url": "https://research.draconitic.com/paper/4k01e1ezjh51v",
  "venue": "Future Healthcare Journal",
  "versions": []
}