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Driving improvement in A&E services
  1. Geoffrey Hughes
  1. Correspondence to Professor Geoffrey Hughes, Emergency Department, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia 5000, Australia; cchdhb{at}

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In October last year the Foundation Trust Network ( published a document with the above title.1 Although much of what it says is of little surprise, it has some interesting comments about filling a medical roster. Using a benchmarking study and comparable and validated information from several trusts (major specialist trauma centres to primary care-led urgent-care centres) the Network has some key messages:

  • The 3% annual growth in A&E (sic) attendances shows no sign of declining.

  • Patients aged ≥75 years account for over 12% of A&E attendances; nearly half of these end in admission.

  • Chronic repeat attenders account for up to 8% of all attendances.

  • Services must be responsive to the needs of their local populations—for example, by providing dedicated specialist geriatric care in A&E for frail elderly patients.

  • Primary and community services can be more available and responsive to the needs of patients with mental health …

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  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed.