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Elevate - Identifying innovative models of emergency care in rural and coastal areas in England: a mixed methods study

Background

England’s Emergency Departments are under pressure, and patients are experiencing long waiting times. Rural and coastal towns have older populations, with poorer health. These communities face unique challenges. For example, summer tourism can dramatically increase the number of people using coastal urgent and emergency care services. As a result, people who live in rural and/or coastal areas find it more difficult to access health services than people in urban settings. Finding new ways of providing urgent and emergency care in rural and coastal areas is a priority for the NHS and UK government. Changes need to be designed with the needs of local patients and local problems in mind.

What are we doing

Through three packages of work, we will aim to gain a better understanding of how emergency care is being transformed in rural and/or coastal areas.

• Part 1: We will use documents (e.g. announcements on NHS England’s website and academic research papers) and interviews with key national (e.g. staff from the Department of Health and Social Care) and local (e.g. Emergency Departments leads) people involved in providing urgent and emergency care in rural and/or coastal communities in England. This will tell us the ways that Emergency Departments in rural and/or coastal communities are designing their services to try and improve emergency care and reduce pressure. This information will also tell us which areas we may want to explore in more detail in part 3 of this research.
• Part 2: We will use statistical analysis of large datasets from the NHS to explore how different ways of providing urgent and emergency care in rural and/or coastal towns may affect patients’ health, costs to the NHS and key measures of emergency department performance such as attendances, waiting time or the number of people admitted to hospital.
• Part 3: We will spend several days at a time at 12 emergency departments in rural and/or coastal areas. We will watch how doctors, nurses and other staff work. We will talk to patients within emergency departments. This will help us to explore, in detail, new ways of providing emergency care in these areas and why certain models may work better in different situations and for different people.

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