Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Oct 1;70(699):e740-e748.
doi: 10.3399/bjgp20X712793. Print 2020 Oct.

Emergency admission risk stratification tools in UK primary care: a cross-sectional survey of availability and use

Mark Kingston  1 , Rhiannon Griffiths  2 , Hayley Hutchings  3 , Alison Porter  1 , Ian Russell  1 , Helen Snooks  1
Affiliations

Emergency admission risk stratification tools in UK primary care: a cross-sectional survey of availability and use

Mark Kingston et al. Br J Gen Pract. .

Abstract

Background: Stratifying patient populations by risk of adverse events was believed to support preventive care for those identified, but recent evidence does not support this. Emergency admission risk stratification (EARS) tools have been widely promoted in UK policy and GP contracts.

Aim: To describe availability and use of EARS tools across the UK, and identify factors perceived to influence implementation.

Design and setting: Cross-sectional survey in UK.

Method: Online survey of 235 organisations responsible for UK primary care: 209 clinical commissioning groups (CCGs) in England; 14 health boards in Scotland; seven health boards in Wales; and five local commissioning groups (LCGs) in Northern Ireland. Analysis results are presented using descriptive statistics for closed questions and by theme for open questions.

Results: Responses were analysed from 171 (72.8%) organisations, of which 148 (86.5%) reported that risk tools were available in their areas. Organisations identified 39 different EARS tools in use. Promotion by NHS commissioners, involvement of clinical leaders, and engagement of practice managers were identified as the most important factors in encouraging use of tools by general practices. High staff workloads and information governance were identified as important barriers. Tools were most frequently used to identify individual patients, but also for service planning. Nearly 40% of areas using EARS tools reported introducing or realigning services as a result, but relatively few reported use for service evaluation.

Conclusion: EARS tools are widely available across the UK, although there is variation by region. There remains a need to align policy and practice with research evidence.

Keywords: Primary care; clinical prediction rule; emergency health services; health care surveys; implementation science; risk stratification.

PubMed Disclaimer

References

    1. Nuffield Trust Choosing a predictive risk model: a guide for commissioners in England. 2011 https://www.nuffieldtrust.org.uk/resource/choosing-apredictive-risk-mode... (accessed 7 Sep 2020).
    1. NHS England Using case finding and risk stratification: a key service component for personalised care and support planning. 2015 https://www.england.nhs.uk/publication/making-it-happen-case-finding (accessed 7 Sep 2020).
    1. National Audit Office Emergency admissions to hospital: managing the demand. 2013 https://www.nao.org.uk/report/emergency-admissionshospitals-managing-demand (accessed 7 Sep 2020).
    1. Steventon A, Deeny S, Friebel R, et al. Emergency hospital admissions in England. Which may be avoidable and how? 2018 https://www.health.org.uk/publications/emergency-hospital-admissions-in-... (accessed 7 Sep 2020).
    1. Wallace E, Stuart E, Vaughan N, et al. Risk prediction models to predict emergency hospital admission in community-dwelling adults: a systematic review. Med Care. 2014 doi: 10.1097/mlr.0000000000000171. - DOI - PMC - PubMed

Publication types

LinkOut - more resources