1. School Business Managers’ Briefing 13 November 2015 Miss Susie Hewitt Consultant Emergency Medicine DHFT

3. Essential facts regarding A&E Services 2014 saw 14.6 million patient attendances to A&E; 30 patients per minute. Children account for around 25% of attendances The increase in attendances in 2014 was equivalent to the workload of 7 large A&Es Every 1% rise in attendances equals the annual workload of two large departments. 15% of patients (> 2 million) could be seen in a non-hospital setting. A&E attendance rates vary by up to 400% according to GP availability. Attendance rates are highest in summer, admission rates are highest in winter. Sundays and Mondays are the busiest days. All aspects of care are compromised in crowded departments, harming both patients and staff.

4. A&E units missed their four-hour target to see, treat or discharge A&E patients - the 12th time in 13 months performance has dropped below 95%

7. The red box

9. School 8% of red box referrals Comment in notes that parents not sure why they are here?? Appear to inappropriately access hospital when could access GP or reassure with basic first aid Musculoskeletal chest pain Insect bites Minor Head injury Undetectable injuries on arrival to CED (scratch to knee, wrist injury, ?leg injury, banged thumb, ?injuries Splinter in finger

11. Our message We are a system under pressure with unsustainable rise in activity Global health community message is to self care in the first instance and use services appropriately CED should not be the default place to come unless a genuine emergency ? minor injury, wound, head injury - go to MIU ? illness review then GP, WIC or DUCC ? need 999 then CED

12. For discussion How to influence children and young people who are the parents of the future Availability of global advice sheets, referral templates, pathways Links with Clinical improvement Groups: local forums for primary and secondary care clinicians to jointly develop and improve clinical services and patient pathways.

13. Key contact Dr Gis Robinson Consultant Paediatric Emergency Medicine Assistant Clinical Director CED Gisela.Robinson@nhs.net