How many patients attending London Emergency Departments could be managed elsewhere? A whole-system review of missed opportunities for care in more appropriate settings
- 1Corresponding author.
- 2NHS England, London Region, 10 South Colonnade, Canary Wharf, London, E14 4PU, United Kingdom
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.
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BibTeX
@article{catherinewilson2026many,
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}},
author = {Catherine Wilson, BA (Hons) Paramedic (HCPC) and Sanjeet Johal, MRPharmS MSc PGDip and Gary Davies, MBBS DipAvMed MD FRCPE and Susan M. Robinson, MB BS FRCP FRCEM},
journal = {Future Healthcare Journal},
year = {2026},
month = oct,
doi = {10.1016/j.fhj.2026.100572},
url = {https://doi.org/10.1016/j.fhj.2026.100572},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - How many patients attending London Emergency Departments could be managed elsewhere? A whole-system review of missed opportunities for care in more appropriate settings
AU - Catherine Wilson, BA (Hons) Paramedic (HCPC)
AU - Sanjeet Johal, MRPharmS MSc PGDip
AU - Gary Davies, MBBS DipAvMed MD FRCPE
AU - Susan M. Robinson, MB BS FRCP FRCEM
PY - 2026
DA - 2026/10/07
JO - Future Healthcare Journal
DO - 10.1016/j.fhj.2026.100572
UR - https://doi.org/10.1016/j.fhj.2026.100572
AB - 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.
SN - 2514-6645
SN - 2514-6653
ER -