Reducing avoidable use and frequent admissions to accident and emergency and avoiding frequent hospital admissions - The ED Project

Understanding the socioeconomic-demographic factors that contribute to local and national patient ED attendances are crucial. These include analyses of factors such as patient deprivation, ethnicity, vulnerability, urban/rural status, distance to hospital, age, sex, morbidity and mortality and the prevalence of health behaviors such as smoking, alcohol consumption (Cathain et al., 2014). Research continuously suggests that the highest potential for reduction in emergency admissions lies with understanding how healthcare services can provide care to deprived communities in ways that avoid emergency admission (Cathain et al., 2014). Furthermore, the growing literature also suggests that the patient’s perception of urgency plays an influential role in ED attendances. Distrust in GPs can lead patients to regard ED visits as ‘necessary,’ even when they are clinically avoidable (Calastri et al., 2025). Whilst delivering quality primary care has been linked to fewer admissions (Steventon et al.,2017), the public’s lack of trust compounded with limited access to primary care services appears to be a systemic problem (O’Cathain et al., 2020; Scantlebury, 2022). Over the past three decades, ED attendances in the UK have risen sharply, with a significant proportion deemed ‘avoidable’ yet reflecting complex patient decision-making, unmet needs, and systemic barriers in accessing primary and community care. Frequent attenders and preventable admissions contribute to overcrowding, delays, and financial strain on the NHS, highlighting the importance of addressing socioeconomic inequalities, trust in primary care, and patient perceptions of urgency.