PEOPLE who regularly attend Somerset’s emergency departments are getting additional help to find services that can better meet their needs.

This is all thanks to a high intensity use (HIU) service, which was set up by Somerset NHS Foundation Trust in August 2023 to monitor and provide support to those patients who frequently use A&E, helping to identify the unmet need and get people the right care in the right place.

The service has proven successful in its first year, with the number of attendances by this cohort of patients dropping by 58 per cent in the first nine months.

Neil Thomas, Somerset NHS Foundation Trust’s high intensity use service lead, explained: “Research shows that there’s a clear link between a high intensity use of emergency services and wider health inequalities, such as age, housing instability, social isolation, loneliness, deprivation, as well as poor physical and mental health.

“A very small percentage of patients account for 16 per cent of all emergency department attendances in Somerset, as well as 26 per cent of hospital admissions, and 29 per cent of those brought to hospital by ambulance.

“Our service is helping us to identify those people who are our top attenders, so we can find out about their unmet needs in the community, and what we’re not getting right for them.”

Across Somerset, the NHS Somerset Integrated Care Board set up three separate high intensity use committees, representing the emergency departments at Musgrove Park and Yeovil hospitals, as well as the first ever high intensity use service for under-18s in the country.

“We set up a full data reading system across both emergency departments, so anyone identified as attending at least 10 times in three months, are now discussed at our committee meetings, which are attended by a range of clinicians and non-clinicians from different agencies.

“Depending on the patient’s needs, we may then ask our colleagues at Ubuntu, which is run by the Community Council for Somerset to find non-healthcare alternatives for people, to create a non-clinical approach at pace, pulling together services and thinking differently around the individual’s needs.

“It’s very much about understanding the little things that matter so much to people, like somebody needing a ramp built up to their front door because they have significant pain that means they can’t use steps, and that was causing them to fall, which in turn caused them to phone for an ambulance.

“Other examples include how a young woman on the neurodiverse spectrum was scared of the dark, and ended up calling the police and ambulance multiple times during the winter because she was getting home in the dark – and was scared to go inside.

“The Ubuntu team got her a timer plug on a lamp, so at 5pm the lamp went on. It can be those things that may seem very simple to others, but can make all the difference to those people.

“From this insight, we can develop personalised support plans that are shared across all of our medical and emergency systems, ensuring that the patient has a voice throughout.”