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Improving care for emergency department frequent attenders

Emergency Department (A&E) sign

In September 2018 the Oxford AHSN  (Now known as Health Innovation Oxford and Thames Valley) received funding from the Health Foundation Q Exchange to support a year-long regional collaboration sharing best practice in relation to Emergency Department (ED) frequent attenders.

The initiative sought to identify best practice, working with service users to explore how EDs can best assess their needs. The clinical lead was Dr Deon Louw, an ED consultant from Oxford University Hospitals. A learning event in May 2019 brought together teams from across the Thames Valley and beyond and received invaluable input from former high intensity service users.

The aim was to improve ED mental healthcare through peer support of teams across the Thames Valley incorporating the following objectives:

  • analysing data on attendance patterns to identify variation and overlap between departments throughout the region
  • sharing frequent attenders programme models across the Thames Valley region to identify and implement best practice and looking at which interventions may be particularly effective
  • involving service users to devise strategies that will enable us to understand and better meet their unique needs.

The work also included:

  • exploring with Thames Valley teams the different models in place locally
  • developing with service users a co-designed psycho-social assessment form to help standardise the way we understand some of the most complex patients
  • analysis of pseudonymised data sets to assess the extent to which patients may be frequently attending several EDs in the Thames Valley, allowing teams to collaboratively discuss strategies as well as seeking to understand the need this is meeting for service users.

Further information:

  • Dr Deon Louw, Clinical Lead, Locum Consultant in Emergency Medicine, Emergency Department Lead for Mental Health, Oxford University Hospitals NHS Foundation Trust