Linking data to build a bigger picture of paediatric referral pathways

Urgent short-stay admissions in children and young people make an important contribution to the burden on the National Health Service (NHS), and have become more common over recent decades, representing almost half of all emergency admissions for this age group.1 These short-stay admissions occur when an individual is admitted and discharged on the same day and are often related to minor conditions, particularly minor infections, asthma, epilepsy and acute tonsillitis, which could be treated outside hospital. While some short-stay admissions are appropriate and should be seen as positive, especially for those who have complex conditions, avoiding unnecessary admissions not only reduces the burden on healthcare services and costs for hospitals, but could also help reduce emotional distress and disruption for families, and the spread of infectious disease.

Potential drivers of the increase in short-stay admissions in the UK have historically included reduced access to general practice (GP) services, lack of trained paediatricians in emergency departments and wait time targets that incentivise admission rather than longer observation times in Accident and Emergency.2 3 More recently, the immense pressures on services following the COVID-19 pandemic have exacerbated these issues. Understanding the paediatric referral pathway is therefore key to identifying opportunities to intervene, and this was one of the aims of the FLAMINGO Study, which reports findings on the proportion of short stay admissions referred by primary care, emergency departments and out-of-hours services in this issue.

The paper by Dick et al 4 highlights a major challenge for studies aiming to understand how different parts of the health …

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