A&E focus on frequent attenders
Patients who repeatedly use A&E are coming under the spotlight as part of an initiative to understand why they attend so frequently.
Harshal Goswami is one of two High Intensity User Case Workers employed by the trust’s emergency departments earlier this summer.
High intensity users who attend A&E at least six times in as many months include those living with mental health conditions, alcohol and substance abuse, long term medical conditions, dementia and frailty, and medically unexplained symptoms.
It is part of a year-long pilot across eight London boroughs and seven emergency departments including Ealing and Northwick Park.
Harshal said: “We have one individual who has come in more than 50 times but when under observation shows no signs of distress or ill health.
“We look into a patient’s medical history and socio-economic situation to see if there are any underlying patterns to their behaviour and what we can do to help.
“It involves some detective work and I liaise with everyone from housing and social services to community and voluntary groups if we spot a trigger which may be causing frequent attendances.
“It can be something as simple as loneliness or poor living accommodation and we work with agencies to address that.
"Alternatively, it can be people who aren’t confidant enough to self-manage an existing condition like COPD so we link them up with the appropriate support."
At present, the team investigate up to 25 cases a month.
Harshal added: “GPs face the same challenges but have a far more comprehensive picture of a patient’s history in the shape of a Universal Care Plan which we try and get hold of.
“It’s all about cause and effect. If we take a step back and find out why something is happening we can hopefully change the outcome.”