New report examines impact of COVID-19 on Accident and Emergency attendances

Entrance sign for Accident and Emergency Department

A new report has found that the number of people attending Accident and Emergency departments in Greater Manchester remained consistent with pre-pandemic levels after lockdowns eased in Summer 2021.

The report, titled “Rise in demand and reasons for A&E attendances in Greater Manchester” was prepared by the Utilisation Management Unit, part of Health Innovation Manchester. It was commissioned in order to examine if A&E departments in the city-region were experiencing a perceived rise in demand.

During the first wave of the COVID-19 pandemic in 2020, attendances at A&E departments in GM reduced by more than 40%. These reductions were a consequence of the lockdown, lower prevalence of minor illness and respiratory disease, fewer injuries, people avoiding A&E because of government campaigns or fear of catching COVID-19.

However, as lockdowns eased the number of people attending A&E began to rise, with concerns of “significant rising demand” as a result of the COVID-19 pandemic.

In May 2021, the Utilisation Management (UM) Unit was asked to quantify the extent of the rise in demand. Using data from 2017-2019 the UM team generated forecasts for A&E attendances in 2021 and discovered no evidence that attendances were exceeding forecast numbers, with the number of people “self-presenting at A&E) remaining below forecast.

The UM team were also asked support the delivery of the GM-wide A&E patient survey with the aim to understand the reasons why people choose to attend A&E. The survey covered ~40% of self-presenters across two days, with ~2000 responses and it provides a good sample to shed light on the reasons for people attending A&E.

The survey found that the reasons for attending A&E were ordinary, and the presenting conditions “typical of the season.”

The report, prepared by Andy Mullarkey, Head of Analytics in the UM team, concludes: “People came to A&E because they had been told to by a GP, other HCP or 111. They believed their issue to be urgent and expected to find out what was wrong with them, to have a test or X-Ray, to be treated today or be seen by an A&E doctor. A significant proportion had seen a GP in the 7 days prior to the attendance or had contacted services before attending A&E.

“There have been several COVID-19 response related hypotheses proposed for the increase in A&E attendances, however, numbers are consistent with what was predicted pre-pandemic. The factors behind rising A&E attendances remain those underlying drivers that existed pre-COVID, rather than the result of actions during COVID-19 i.e. fewer face-to-face GP appointments.”

Dr Paula Bennett, Associate Director of Clinical Development/Utilisation Management Unit, said: “Understanding the impact of the COVID-19 pandemic on our accident and emergency services through data analysis is vital to help our local health and care system respond to demand and plan for the future.

“By examining the data pre-pandemic data and current attendances we’re able to show that the current “rise in demand” is A&E attendances returning to normal levels after lower attendances during the early pandemic lockdowns. There is always an annual increase in A&E department attendances of approximately 2%. Several of our A&E departments have seen changes in demand no consistent with predicted levels but overall, we are seeing a return to predicted demand. The patient survey also shows that the reasons for people attending at A&E remain the same as before COVID-19.

“We are proud to be collaborating with the Greater Manchester system with this work and supporting our partners.”

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