24 April 2017
Eilís Keeble

Eilís Keeble

Research Analyst
Nuffield Trust

Children and young people use hospital emergency care more than you may think. They are more likely than adults to visit A&E with over four A&E attendances for every ten children and young people in 2015/16. Compared with ten years ago, children and young people are also more likely to be admitted to hospital in an emergency. With so much of the focus in the media on the older population and the NHS, you would be forgiven for thinking that children and young people aren’t part of this picture. However, there are opportunities for improving their care and they should not be overlooked.

Missed opportunities?

We can’t stop children and young people developing conditions like asthma, epilepsy and acute tonsillitis but we can make sure they receive the best care possible. We found that ‘acute and chronic tonsillitis’ was the sixth most common reason for a child or young person to be admitted to hospital in an emergency in 2015/16. Despite improvements, asthma and epilepsy are also still among the ten most common reasons that children and young people are being admitted to hospital in an emergency.

High numbers of emergency admissions for these conditions says more about the quality of care outside the emergency setting as intervening early with appropriate planned or preventative care could help prevent some of these admissions. For example, there are routine care interventions, such as condition management plans and regular medication assessments, that can be put in place that are known to reduce the likelihood of emergency admission for conditions like asthma.

Providing appropriate support and high quality care to children and young people to help them better manage their condition can only be a good thing if it empowers the individual and as an added bonus, reduces emergency hospital use.

The importance of getting it right first time

It is well recognised that what you experience in your childhood and early life impacts on later life. Whether it is simply what you learnt, to the impact of your diet, to the effects of childhood mental illness or obesity. All of these have been shown to have long term consequences, be they positive or negative, on your health and wellbeing. This matters to you but it should also matter to everyone else. A healthy population is more productive and demands less of the NHS and of wider society.

We currently have a generation of over 16 million children and young people, the majority of which will go on to use the NHS in some way in their lives. Intervening early and helping those with conditions such as asthma or epilepsy to better manage their condition will have benefits now but also long into the future as it is likely they will continue to manage their condition well. Habits are hard to kick especially those you've had all your life.

Time to take action

The opportunities need to be seized upon. The new care models for children and young people are doing this by trying out different ways of providing care including involving paediatric consultants in care in the community for children and young people with long-term conditions. The argument has been made previously for the value of these models and their successes should be monitored closely but there is always more that can be done. We should be trying to learn and understand more about the care needs of children and young people and making sure they aren’t overlooked. If we get healthcare right for them first time, it's not only good for them but perhaps there will also be less pressure on the NHS and social care in the future.

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