Preventing emergencies: Swansea team pioneer trial of new NHS system

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Emergency admissions to hospital are expensive to the NHS and very distressing for patients and their families, with around 350,000 cases in Wales last year. Now a Swansea University-led research team, working with patients and NHS staff, is examining a new way to tackle unnecessary admissions, to see if it makes a real difference.

Wales is leading the way internationally in this area.  Researchers from Swansea University’s College of Medicine have funding from the National Institute for Health Research Health Services and Delivery Research (HS&DR) Programme to carry out the first study on this scale, looking at the impact on patients of this new system.   

‌The Swansea-led study, called PRISMATIC, is evaluating a tool called Prism, which is now being trialled by many GPs in the ABMU Health Board area.  It allocates people a score from 1 to 100 depending on their risk of being admitted as an emergency. 

Identifying high-risk people means they can be given extra support in the community, to improve health and prevent the distress and disruption of emergency admissions.

Watch BBC coverage of the team's research

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The Swansea team will be comparing GP practices which use the tool with those who don’t, and using hospital data to see whether it makes a difference in reducing admissions.  They’re also asking patients whether they think it’s made a difference to them, and getting feedback from NHS staff about how they use the tool, and what they think of it.

Professor Helen Snooks of Swansea University's College of Medicine, whose team are conducting the research, said:

“Preventing unnecessary admissions is good for the patient and good for the NHS.  The new scoring system could help the NHS do this, but we need to be sure that it works in practice.

By collaborating with ABMU Health Board,  our study is looking at the real effects on patient care and resources.  It’ll show whether it’s making a real difference.  

This is research that can help us inform policy and practice, to help improve health and the NHS.  With our high numbers of older people, and high levels of chronic illness, the problem is especially acute in Wales.  But it’s fitting that we’re also at the forefront of research to help tackle the problem."

Shirley Whitman and Dr Deborah Burge-JonesShirley Whitman (pictured left), who is taking part in the study, was a carer for her late husband who was admitted to hospital as an emergency on several occasions.

“It’s very frightening when someone you care for is rushed into hospital. It would be much better to avoid crisis situations by getting the right care at the right time.

An emergency admission is too late.”

Dr Deborah Burge-Jones (also pictured above) is a GP from the Wilkes Practice in Briton Ferry Health Centre in Neath Port Talbot.  She said:  

“We have higher rates of ill-health here in Neath Port Talbot.   I see it with my patients. Prism would provide new information and has great potential for improving patient care, but we need to be sure that it makes a real difference. 

Getting the evidence is crucial, which is why this project is so important.“

400 x 314Picture:  screen shot of the Prism system, showing how patients are allocated a risk level and score.

The team, based at Swansea University College of Medicine, is part of the TRUST research network on unscheduled, emergency and trauma care.

The project is a collaboration between Abertawe Bro Morgannwg University Health Board, the Welsh Government, NHS Wales Informatics Service and the service user representative group SUCCESS. BMA representatives were involved in the study setup.


The research is supported by the National Institute of Social Care & Health Research Clinical Research Collaboration